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General NPI Number Information
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NPI Number | 1215636113
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Entity Type | Individual
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Provider Name | T'NAZJA SCOTT
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Gender | Female
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 5525 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-2782
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Country | US
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Telephone | 219-525-1690
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Fax |
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Provider Business Mailing Address
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Address Line | 127 QUICK RD
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City | NEW CARLISLE
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State | OH
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Zip | 45344-9253
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Country | US
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Telephone | 937-845-3628
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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