Provider Demographics
NPI:1518101575
Name:SCOTT, CHANTAL (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHANTAL
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 ALDERSYDE DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-9581
Mailing Address - Country:US
Mailing Address - Phone:817-741-1559
Mailing Address - Fax:
Practice Address - Street 1:3509 ALDERSYDE DR
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-9581
Practice Address - Country:US
Practice Address - Phone:817-741-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101669235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist