Provider Demographics
NPI:1497967723
Name:ACTON, WILLIAM SCOTT (MA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:ACTON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17531 W DALEA DR
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-5869
Mailing Address - Country:US
Mailing Address - Phone:623-386-6830
Mailing Address - Fax:623-877-9545
Practice Address - Street 1:17531 W DALEA DR
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-5869
Practice Address - Country:US
Practice Address - Phone:623-386-6830
Practice Address - Fax:623-877-9545
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool