Healthcare Provider Details

I. General information

NPI: 1770497174
Provider Name (Legal Business Name): SARAH AALIYAH SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6511 JOHNSON DR
MISSION KS
66202-2616
US

IV. Provider business mailing address

4304 E 113TH TER
KANSAS CITY MO
64137-2451
US

V. Phone/Fax

Practice location:
  • Phone: 573-203-3699
  • Fax:
Mailing address:
  • Phone: 660-383-6112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: