Provider Demographics
NPI:1053645382
Name:SCOTT, ANTOINETTE R (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:R
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 MAIN ST STE 303
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6050
Mailing Address - Country:US
Mailing Address - Phone:860-643-2701
Mailing Address - Fax:
Practice Address - Street 1:935 MAIN ST
Practice Address - Street 2:SUITE 303
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-6059
Practice Address - Country:US
Practice Address - Phone:860-643-2701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker