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General NPI Number Information
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NPI Number | 1457974479
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Entity Type | Individual
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Provider Name | AMBER LYNN SCOTT
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Gender | Female
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 05/26/2020
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Provider Practice Location Address
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Address Line | 2940 INLAND EMPIRE BLVD
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City | ONTARIO
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State | CA
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Zip | 91764-4898
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Country | US
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Telephone | 951-205-5045
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 71012
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City | RIVERSIDE
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State | CA
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Zip | 92513-1012
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6478
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 113789
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License Number State | CA
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