Healthcare Provider Details

I. General information

NPI: 1427945088
Provider Name (Legal Business Name): STEVIE O SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 NEBRASKA AVE
TOLEDO OH
43607-3243
US

IV. Provider business mailing address

2251 PORTSMOUTH AVE
TOLEDO OH
43613-4416
US

V. Phone/Fax

Practice location:
  • Phone: 419-318-8847
  • Fax:
Mailing address:
  • Phone: 567-277-3077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: