Provider Demographics
NPI:1821707092
Name:SCOTT, SHAMEKA SELF
Entity Type:Individual
Prefix:MRS
First Name:SHAMEKA
Middle Name:SELF
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 1:1514 SEAGLER POND LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-2800
Mailing Address - Country:US
Mailing Address - Phone:832-801-7815
Mailing Address - Fax:
Practice Address - Street 1:1514 SEAGLER POND LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-2800
Practice Address - Country:US
Practice Address - Phone:832-801-7815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician