Provider Demographics
NPI:1295017267
Name:SCOTT, JENNIFER M (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 W CHAPMAN RD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8895
Mailing Address - Country:US
Mailing Address - Phone:407-324-7772
Mailing Address - Fax:321-248-0717
Practice Address - Street 1:113 W CHAPMAN RD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8895
Practice Address - Country:US
Practice Address - Phone:407-324-7772
Practice Address - Fax:321-248-0717
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-08-4100103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst