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General NPI Number Information
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NPI Number | 1003331679
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Entity Type | Organization
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Legal Business Name | BRIGHAM S SCOTT
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 1530 S 70TH ST STE 102
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City | LINCOLN
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State | NE
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Zip | 68506-1567
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Country | US
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Telephone | 402-540-2303
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Fax | 402-540-2303
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Provider Business Mailing Address
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Address Line | PO BOX 326
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City | VALPARAISO
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State | NE
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Zip | 68065-0326
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Country | US
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Telephone | 402-875-2433
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIGHAM S SCOTT
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Credential | PSYD
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Telephone | 402-540-2303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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