MEDICARE: DR. LYNNE D SCOTT ED,D,,L.M.F.T.

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	106H00000X	Marriage & Family Therapist	MFT000731	GA

General Provider Information

NPI Number	:	1558370288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNNE D SCOTT ED,D,,L.M.F.T.

Provider Business Mailing Address
First Line	:	PO BOX 519
Second Line	:
City	:	REX
State	:	GA
Zip	:	30273-0519
Country	:	US
Telephone Number	:	770-961-6281
Fax Number	:	770-961-1434

Provider Business Practice Location Address
First Line	:	6188 HIGHWAY 42
Second Line	:
City	:	REX
State	:	GA
Zip	:	30273-1028
Country	:	US
Telephone Number	:	770-961-6281
Fax Number	:	770-961-1434

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/09/2007

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