Provider Demographics
NPI:1235782814
Name:FOOR, SCOTT EDWARD (MA)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:EDWARD
Last Name:FOOR
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2353 N 9TH ST LOT A111
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-1609
Mailing Address - Country:US
Mailing Address - Phone:805-704-0721
Mailing Address - Fax:
Practice Address - Street 1:2353 N 9TH ST LOT A111
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-1609
Practice Address - Country:US
Practice Address - Phone:805-704-0721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY69611251B00000X, 253Z00000X, 305R00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care
No305R00000XManaged Care OrganizationsPreferred Provider Organization