Provider Demographics
NPI:1518098946
Name:SCOTT, MARY C (MA CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:C
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8381 COLERAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-3924
Mailing Address - Country:US
Mailing Address - Phone:513-923-4999
Mailing Address - Fax:513-923-9184
Practice Address - Street 1:3404 WERK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-6813
Practice Address - Country:US
Practice Address - Phone:513-662-1700
Practice Address - Fax:513-793-2225
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.00963237600000X
237700000X
OHA-0963237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000222973OtherANTHEM INSURANCE
OH3033710Medicaid