MEDICARE: FELICIA DENISE SCOTT CNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	NA08751174	TX

General Provider Information

NPI Number	:	1124308317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA DENISE SCOTT CNA

Provider Business Mailing Address
First Line	:	9020 MILL VALLEY CIR APT 237
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76120-4824
Country	:	US
Telephone Number	:	817-363-6051
Fax Number	:

Provider Business Practice Location Address
First Line	:	9020 MILL VALLEY CIR APT 237
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76120-4824
Country	:	US
Telephone Number	:	817-363-6051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2011
Last Update Date	:	08/19/2011

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