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General NPI Number Information
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NPI Number | 1588797161
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Entity Type | Individual
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Provider Name | KELLY MARIE SCOTT LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 701 S 8TH ST
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City | MCLOUD
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State | OK
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Zip | 74851-8500
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Country | US
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Telephone | 405-964-2961
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Fax |
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Provider Business Mailing Address
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Address Line | RR 4 BOX 114-A
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City | TECUMSEH
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State | OK
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Zip | 74873-9101
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Country | US
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Telephone | 405-740-3128
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2940
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License Number State | OK
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