Provider Demographics
NPI:1326508078
Name:SCOTT, DAVONNA ASHLEY (MS)
Entity Type:Individual
Prefix:
First Name:DAVONNA
Middle Name:ASHLEY
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 VININGS TRL SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-8642
Mailing Address - Country:US
Mailing Address - Phone:757-617-3022
Mailing Address - Fax:
Practice Address - Street 1:1402 VININGS TRL SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-8642
Practice Address - Country:US
Practice Address - Phone:757-617-3022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health