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General NPI Number Information
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NPI Number | 1376628164
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Entity Type | Individual
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Provider Name | BONNIE JOY SCOTT PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 215 W MCELROY RD SUITE 1
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City | STILLWATER
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State | OK
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Zip | 74075-3537
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Country | US
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Telephone | 405-372-5292
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Fax | 775-667-7677
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Provider Business Mailing Address
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Address Line | 1205 W OSAGE DR
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City | STILLWATER
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State | OK
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Zip | 74075-2142
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Country | US
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Telephone | 405-372-0734
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Fax | 775-667-7677
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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 | 569
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License Number State | OK
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