Healthcare Provider Details

I. General information

NPI: 1649015132
Provider Name (Legal Business Name): TAMERA SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 LEXINGTON AVE
ASHVILLE OH
43103-1238
US

IV. Provider business mailing address

96 LEXINGTON AVE
ASHVILLE OH
43103-1238
US

V. Phone/Fax

Practice location:
  • Phone: 614-603-8164
  • Fax:
Mailing address:
  • Phone: 614-603-8164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberUB524234
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: