Provider Demographics
NPI:1558578088
Name:SCOTT, ADRIEN MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:ADRIEN
Middle Name:MICHELLE
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 1:61 SOMERSET RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2838
Mailing Address - Country:US
Mailing Address - Phone:734-776-8796
Mailing Address - Fax:
Practice Address - Street 1:61 SOMERSET RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-2838
Practice Address - Country:US
Practice Address - Phone:734-776-8796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2536116251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2536116OtherODMRDD CONTRACT NUMBER
OH2713696Medicaid