Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ||
Y | 1041C0700X | Clinical Social Worker | 6315 | KY |
NPI | 1003491952 |
---|---|
Provider Name | Elizabeth Christine Scott |
First Address | Louisville, KY 40222-4677 |
Second Address | Louisville, KY 40222-4677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2021 |
Last Update Date | 12/03/2021 |