Provider Demographics
NPI:1114336088
Name:SCOTT, ALISON JO (AUD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:JO
Last Name:SCOTT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:JO
Other - Last Name:VANAMBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:2530 CHICAGO AVE. S.
Mailing Address - Street 2:SUITE 450
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404
Mailing Address - Country:US
Mailing Address - Phone:612-813-7610
Mailing Address - Fax:
Practice Address - Street 1:2530 CHICAGO AVE. S.
Practice Address - Street 2:SUITE 450
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404
Practice Address - Country:US
Practice Address - Phone:612-813-7610
Practice Address - Fax:612-813-6889
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9338231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist