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General NPI Number Information
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NPI Number | 1346369550
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Entity Type | Individual
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Provider Name | JEAN M SCARLETT LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 627 S EDWIN C MOSES BLVD EAST MEDICAL PLAZA 6TH FLOOR
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City | DAYTON
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State | OH
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Zip | 45408-1461
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Country | US
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Telephone | 937-461-9150
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Fax |
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Provider Business Mailing Address
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Address Line | 28 FAIRWOOD DR
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City | MIAMISBURG
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State | OH
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Zip | 45342-6628
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Country | US
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Telephone | 937-859-0468
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801081137
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License Number State | MI
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