Provider Demographics
NPI:1407999485
Name:SCOTT, MONICA SUE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:SUE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CHIFFON LN
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-2296
Mailing Address - Country:US
Mailing Address - Phone:501-617-8039
Mailing Address - Fax:501-321-6094
Practice Address - Street 1:1910 MALVERN AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7752
Practice Address - Country:US
Practice Address - Phone:501-620-1316
Practice Address - Fax:501-321-6095
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1220235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR13042372Medicaid
ARSP#1220OtherSTATE LICENSURE
09116145OtherAMERICAN SPEECH LANG ASSO