Provider Demographics
NPI:1619403268
Name:SCOTT, DELLA
Entity Type:Individual
Prefix:
First Name:DELLA
Middle Name:
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 1:320 S ORANGE AVE
Mailing Address - Street 2:3E
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2133
Mailing Address - Country:US
Mailing Address - Phone:862-290-6488
Mailing Address - Fax:
Practice Address - Street 1:320 S ORANGE AVE
Practice Address - Street 2:3E
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2133
Practice Address - Country:US
Practice Address - Phone:862-290-6488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor