Provider Demographics
NPI:1568741692
Name:SCOGGIN, AMBER LYNN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:SCOGGIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12732 HICKORY LITTLE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:MS
Mailing Address - Zip Code:39327-9281
Mailing Address - Country:US
Mailing Address - Phone:601-480-8428
Mailing Address - Fax:
Practice Address - Street 1:781 SCOGGIN RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:MS
Practice Address - Zip Code:39327-9342
Practice Address - Country:US
Practice Address - Phone:601-480-8428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist