Healthcare Provider Details

I. General information

NPI: 1447166228
Provider Name (Legal Business Name): KRYSTAL SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2839
CHEYENNE WY
82003-2839
US

IV. Provider business mailing address

PO BOX 2839
CHEYENNE WY
82003-2839
US

V. Phone/Fax

Practice location:
  • Phone: 307-701-0453
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: