Healthcare Provider Details

I. General information

NPI: 1952469637
Provider Name (Legal Business Name): BARBARA JEAN SCOTT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W FRONTVIEW ST STE 6
DODGE CITY KS
67801-2200
US

IV. Provider business mailing address

106 W FRONTVIEW ST STE 6
DODGE CITY KS
67801-2200
US

V. Phone/Fax

Practice location:
  • Phone: 620-225-4600
  • Fax: 620-225-4646
Mailing address:
  • Phone: 620-225-4600
  • Fax: 620-225-4646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number513
License Number StateKS

VIII. Authorized Official

Name: MS. BARBARA J SCOTT
Title or Position: DIRECTOR
Credential: CADC III
Phone: 620-225-4600