Provider Demographics
NPI:1740777465
Name:SCOTT, KENZIE
Entity Type:Individual
Prefix:
First Name:KENZIE
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 1:25018 OAKHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2722
Mailing Address - Country:US
Mailing Address - Phone:281-364-9695
Mailing Address - Fax:
Practice Address - Street 1:9850 KEY WEST AVE STE 110
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3963
Practice Address - Country:US
Practice Address - Phone:301-765-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC200001494235Z00000X
VA2202010960235Z00000X
TN6593235Z00000X
MD10717235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist