Provider Demographics
NPI:1003885872
Name:SCOTT, GINNIFER STEPHENS (MA, CCC)
Entity Type:Individual
Prefix:MRS
First Name:GINNIFER
Middle Name:STEPHENS
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 W END AVE
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-5154
Mailing Address - Country:US
Mailing Address - Phone:704-873-4476
Mailing Address - Fax:
Practice Address - Street 1:444 W END AVE
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-5154
Practice Address - Country:US
Practice Address - Phone:704-873-4476
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2152235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist