Healthcare Provider Details

I. General information

NPI: 1316603681
Provider Name (Legal Business Name): AMY SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 BECKS WOODS DR
BEAR DE
19701-3851
US

IV. Provider business mailing address

161 BECKS WOODS DR
BEAR DE
19701-3833
US

V. Phone/Fax

Practice location:
  • Phone: 302-365-8333
  • Fax:
Mailing address:
  • Phone: 302-365-8333
  • Fax: 866-334-5338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN-0010910
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: