Healthcare Provider Details

I. General information

NPI: 1336753060
Provider Name (Legal Business Name): SIDNEY LEIGH SCOTT CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2020
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 NEWBURYPORT TPKE STE A8
ROWLEY MA
01969-2132
US

IV. Provider business mailing address

PO BOX 285
HAMPTON FALLS NH
03844-0285
US

V. Phone/Fax

Practice location:
  • Phone: 603-918-1298
  • Fax:
Mailing address:
  • Phone: 603-918-1298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3080298
Identifier TypeMEDICAID
Identifier StateNH
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: