Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | C2696A | AL |
N | 225XM0800X | Mental Health | 1284 | AL |
NPI | 1780118653 |
---|---|
Provider Name | Dr. Marjorie Elizabeth Scaffa |
First Address | Mobile, AL 36609-6113 |
Second Address | Mobile, AL 36609-6113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2017 |
Last Update Date | 17/04/2017 |