Provider Demographics
NPI:1902006737
Name:KNOTT-SCOTT, ENA C (PHD)
Entity Type:Individual
Prefix:DR
First Name:ENA
Middle Name:C
Last Name:KNOTT-SCOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ENA
Other - Middle Name:C
Other - Last Name:KNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1264 WOODDELL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-4045
Mailing Address - Country:US
Mailing Address - Phone:601-371-1005
Mailing Address - Fax:
Practice Address - Street 1:1264 WOODDELL DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39212-4045
Practice Address - Country:US
Practice Address - Phone:601-371-1005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS40-021103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical