Provider Demographics
NPI:1093594244
Name:SCOTT, ELIZABETH FREEMAN (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:FREEMAN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SHIRLEY LN UNIT 2
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-2713
Mailing Address - Country:US
Mailing Address - Phone:336-978-5671
Mailing Address - Fax:
Practice Address - Street 1:197 MARTIN RD
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-9224
Practice Address - Country:US
Practice Address - Phone:716-483-4350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist