Provider Demographics
NPI:1639946114
Name:SCOTT, TASHA
Entity Type:Individual
Prefix:
First Name:TASHA
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 1:2319 BROOKS DR APT 303
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-1021
Mailing Address - Country:US
Mailing Address - Phone:202-270-2728
Mailing Address - Fax:
Practice Address - Street 1:2319 BROOKS DR APT 303
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-1021
Practice Address - Country:US
Practice Address - Phone:202-270-2728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide