Provider Demographics
NPI:1598929697
Name:POPOVICH-SCOTT, ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:POPOVICH-SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:P
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8025 RITCHIE HWY
Mailing Address - Street 2:STE 102
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-1031
Mailing Address - Country:US
Mailing Address - Phone:410-590-5572
Mailing Address - Fax:
Practice Address - Street 1:8025 RITCHIE HWY
Practice Address - Street 2:102
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1031
Practice Address - Country:US
Practice Address - Phone:410-590-5572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2500237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist