Provider Demographics
NPI:1619532322
Name:SCATTERDAY, AMY (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:SCATTERDAY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3113 W BELTLINE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2934
Mailing Address - Country:US
Mailing Address - Phone:608-819-6810
Mailing Address - Fax:224-258-1400
Practice Address - Street 1:3113 W BELTLINE HWY STE 300
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-2934
Practice Address - Country:US
Practice Address - Phone:608-819-6810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-08
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-19-35074103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst