Provider Demographics
NPI:1376846113
Name:SCOTT, CLAIRE Y
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:Y
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TYRE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-7136
Mailing Address - Country:US
Mailing Address - Phone:302-454-2047
Mailing Address - Fax:302-454-5442
Practice Address - Street 1:200 TYRE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7136
Practice Address - Country:US
Practice Address - Phone:302-454-2047
Practice Address - Fax:302-454-5442
Is Sole Proprietor?:No
Enumeration Date:2010-12-17
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE54939103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool