Provider Demographics
NPI:1821616277
Name:SCOTT, LAGLEANIA
Entity Type:Individual
Prefix:
First Name:LAGLEANIA
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 1:5905 AIRWAYS BLVD BLDG 245-4
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-1894
Mailing Address - Country:US
Mailing Address - Phone:662-402-6512
Mailing Address - Fax:
Practice Address - Street 1:7579 WISTERIA DR
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-6982
Practice Address - Country:US
Practice Address - Phone:901-468-3667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant