MEDICARE: KINDRA LEIGH SCOTT

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	104100000X	Social Worker	1149057	AZ

General Provider Information

NPI Number	:	1164887691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KINDRA LEIGH SCOTT

Provider Business Mailing Address
First Line	:	4449 N 12TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-4520
Country	:	US
Telephone Number	:	602-279-1427
Fax Number	:	602-279-1431

Provider Business Practice Location Address
First Line	:	6117 W OREGON AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-6629
Country	:	US
Telephone Number	:	602-279-1427
Fax Number	:	602-279-1431

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

Provider Enumeration Date	:	12/29/2015
Last Update Date	:	12/30/2025

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Directions to “ KINDRA LEIGH SCOTT ” Practice Location

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