MEDICARE: DESTANY 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	374J00000X	Doula		AZ
2	374J00000X	Doula		CA

General Provider Information

NPI Number	:	1366304644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESTANY SCOTT

Provider Business Mailing Address
First Line	:	2030 E PIEDMONT PL
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-6812
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2030 E PIEDMONT PL
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-6812
Country	:	US
Telephone Number	:	951-603-4096
Fax Number	:

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

Provider Enumeration Date	:	11/25/2025
Last Update Date	:	11/25/2025

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Directions to “ DESTANY SCOTT ” Practice Location

Language	Start Address	Practice Location

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