Provider Demographics
NPI:1245015478
Name:BASOAH-SCOTT, NANCY (LMFT ASSOCIATE)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:BASOAH-SCOTT
Suffix:
Gender:F
Credentials:LMFT ASSOCIATE
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:BASOAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4900 ROSE QUARTZ DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5383
Mailing Address - Country:US
Mailing Address - Phone:619-762-8360
Mailing Address - Fax:
Practice Address - Street 1:4900 ROSE QUARTZ DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-5383
Practice Address - Country:US
Practice Address - Phone:619-762-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205187106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist