Provider Demographics
NPI:1689822470
Name:SCOTT, SAMANTHA LOUISE (PHD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LOUISE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4260
Mailing Address - Country:US
Mailing Address - Phone:443-359-0662
Mailing Address - Fax:407-522-4671
Practice Address - Street 1:213 W MAIN ST STE 206
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5098
Practice Address - Country:US
Practice Address - Phone:443-359-0662
Practice Address - Fax:407-522-4671
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05307103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical