Provider Demographics
NPI:1225117062
Name:SCOTT, ROSEMARY (MA-CCC, SLP)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA-CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 CRESTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2736
Mailing Address - Country:US
Mailing Address - Phone:323-259-0510
Mailing Address - Fax:323-258-5566
Practice Address - Street 1:1415 CRESTHAVEN DR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2736
Practice Address - Country:US
Practice Address - Phone:323-259-0510
Practice Address - Fax:323-258-5566
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 3895235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist