Provider Demographics
NPI:1710234638
Name:BRUCE, SCOTT (MS)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:BRUCE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 E 25TH PLZ
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-5255
Mailing Address - Country:US
Mailing Address - Phone:850-866-5821
Mailing Address - Fax:850-215-8731
Practice Address - Street 1:923 E 25TH PLZ
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-5255
Practice Address - Country:US
Practice Address - Phone:850-866-5821
Practice Address - Fax:850-215-8731
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health