Healthcare Provider Details

I. General information

NPI: 1023247418
Provider Name (Legal Business Name): DONNA MARIA SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2702 N 3RD ST SUITE 2000
PHOENIX AZ
85004-1130
US

IV. Provider business mailing address

PO BOX 16906
PHOENIX AZ
85011-6906
US

V. Phone/Fax

Practice location:
  • Phone: 602-279-1427
  • Fax: 602-279-1431
Mailing address:
  • Phone: 602-279-1427
  • Fax: 602-279-1431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1689732
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: