Provider Demographics
NPI:1245751296
Name:SCOTT, TAMIKA D (TAMIKA)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:D
Last Name:SCOTT
Suffix:
Gender:F
Credentials:TAMIKA
Other - Prefix:MS
Other - First Name:TAMIKA
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3825 REDBUD LN
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2138
Mailing Address - Country:US
Mailing Address - Phone:504-439-4255
Mailing Address - Fax:
Practice Address - Street 1:2100 BELLE CHASSE HWY
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-6651
Practice Address - Country:US
Practice Address - Phone:504-367-6630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health