Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 1068 | KY |
NPI | 1003243874 |
---|---|
Provider Name | Sheena Scott |
First Address | Pikeville, KY 41501-5416 |
Second Address | Pikeville, KY 41501-5416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2013 |
Last Update Date | 10/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270795565 | (05) | KY |