Provider Demographics
NPI:1437861358
Name:SCOTT, BLAKNEY
Entity Type:Individual
Prefix:
First Name:BLAKNEY
Middle Name:
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 1:187 COMPTON RD
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-5153
Mailing Address - Country:US
Mailing Address - Phone:508-367-4280
Mailing Address - Fax:
Practice Address - Street 1:187 COMPTON RD
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:OH
Practice Address - Zip Code:45215-5153
Practice Address - Country:US
Practice Address - Phone:508-367-4280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator