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NPI Code Detail

MEDICARE: MISS CONNIE SCOTT AA

MEDICARE: MISS CONNIE SCOTT AA
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
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16803012703OTHERMISOCIAL WORK TECH
24703016071OTHERMINURSING

General Provider Information

NPI Number : 1841313400
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS CONNIE SCOTT AA
Provider Business Mailing Address
First Line : 3646 MOUNT ELLIOTT ST
Second Line :
City : DETROIT
State : MI
Zip : 48207-2311
Country : US
Telephone Number : 313-921-4700
Fax Number : 313-921-4125
Provider Business Practice Location Address
First Line : 3646 MOUNT ELLIOTT ST
Second Line :
City : DETROIT
State : MI
Zip : 48207-2311
Country : US
Telephone Number : 313-921-4700
Fax Number : 313-921-4125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 07/08/2007

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Directions to “ MISS CONNIE SCOTT AA” Practice Location

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