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General NPI Number Information
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NPI Number | 1295877421
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Entity Type | Individual
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Provider Name | BRETT EDWARD SCOFIELD PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1215 HIGH ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-2541
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Country | US
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Telephone | 270-782-1116
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Fax | 270-782-9108
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Provider Business Mailing Address
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Address Line | 850 WILKINSON TRCE APT 240
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City | BOWLING GREEN
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State | KY
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Zip | 42103-2524
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Country | US
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Telephone | 270-846-3063
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Fax | 270-782-9108
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2006-105
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License Number State | KY
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