Healthcare Provider Details

I. General information

NPI: 1164569166
Provider Name (Legal Business Name): JENNIFER LYNN SCOTT PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 CLAYS MILL RD SUITE 213
LEXINGTON KY
40503-3484
US

IV. Provider business mailing address

3320 CLAYS MILL RD SUITE 213
LEXINGTON KY
40503-3484
US

V. Phone/Fax

Practice location:
  • Phone: 859-576-0411
  • Fax:
Mailing address:
  • Phone: 859-576-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1415
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: