Provider Demographics
NPI:1972859668
Name:SCOTT, AMANDA (MT-BC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 MITCHELL BRIDGE RD
Mailing Address - Street 2:#131
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6400
Mailing Address - Country:US
Mailing Address - Phone:706-254-4571
Mailing Address - Fax:
Practice Address - Street 1:700 MITCHELL BRIDGE RD
Practice Address - Street 2:#131
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6400
Practice Address - Country:US
Practice Address - Phone:706-254-4571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist