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General NPI Number Information
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NPI Number | 1356719694
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Entity Type | Individual
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Provider Name | ANTONIO TERRILL SCOTT
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Gender | Male
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 216 WALLS LANE
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City | CHADBOURN
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State | NC
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Zip | 28431
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Country | US
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Telephone | 910-207-2422
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Fax |
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Provider Business Mailing Address
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Address Line | 216 WALLS LN
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City | CHADBOURN
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State | NC
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Zip | 28431-8517
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Country | US
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Telephone | 910-207-2422
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | NC
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