Healthcare Provider Details

I. General information

NPI: 1376703470
Provider Name (Legal Business Name): LEAH DAWN SCOTT MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15818 SW WARFIELD BLVD
INDIANTOWN FL
34956-3513
US

IV. Provider business mailing address

25751 SW 95TH ST
INDIANTOWN FL
34956-4232
US

V. Phone/Fax

Practice location:
  • Phone: 772-597-0411
  • Fax:
Mailing address:
  • Phone: 772-597-0084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: