Provider Demographics
NPI:1336313964
Name:SCOTT, DONNA M (LDN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:PA
Mailing Address - Zip Code:18517-1826
Mailing Address - Country:US
Mailing Address - Phone:570-562-9735
Mailing Address - Fax:570-562-3637
Practice Address - Street 1:730 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:PA
Practice Address - Zip Code:18517-1826
Practice Address - Country:US
Practice Address - Phone:570-562-9735
Practice Address - Fax:570-562-3637
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001390133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered