Provider Demographics
NPI:1124245089
Name:SCOTT, LORIE (MED)
Entity type:Individual
Prefix:
First Name:LORIE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16903 RED OAK DR STE 170
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3929
Mailing Address - Country:US
Mailing Address - Phone:281-440-3304
Mailing Address - Fax:281-587-1762
Practice Address - Street 1:16903 RED OAK DR STE 170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3929
Practice Address - Country:US
Practice Address - Phone:281-440-3304
Practice Address - Fax:281-587-1762
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11757101YP2500X
TX004194106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist