Provider Demographics
NPI:1043562390
Name:SCOTT, THYIAS L
Entity Type:Individual
Prefix:
First Name:THYIAS
Middle Name:L
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5813 FISHER RD
Mailing Address - Street 2:#201
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-5927
Mailing Address - Country:US
Mailing Address - Phone:202-841-0840
Mailing Address - Fax:
Practice Address - Street 1:622 21ST ST NE
Practice Address - Street 2:#1
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4765
Practice Address - Country:US
Practice Address - Phone:202-371-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide