Provider Demographics
NPI:1164767612
Name:SCOTT, ROSLYN M HARDEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSLYN
Middle Name:M HARDEN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 EXECUTIVE PARK DR, NE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329
Mailing Address - Country:US
Mailing Address - Phone:404-633-2335
Mailing Address - Fax:
Practice Address - Street 1:17 EXECUTIVE PARK DR, NE
Practice Address - Street 2:SUITE 510
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329
Practice Address - Country:US
Practice Address - Phone:404-633-2335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1387103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling