Provider Demographics
NPI:1326310202
Name:HOPKINS, SCOTT ROBERT (MACCC/SLP)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ROBERT
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:MACCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 CRIPPEN ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-1419
Mailing Address - Country:US
Mailing Address - Phone:231-779-2123
Mailing Address - Fax:
Practice Address - Street 1:430 CRIPPEN ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-1419
Practice Address - Country:US
Practice Address - Phone:231-779-2123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI01105786235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist