Provider Demographics
NPI:1255629077
Name:SCOTT, WINONA LEE
Entity type:Individual
Prefix:MRS
First Name:WINONA
Middle Name:LEE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:WINONA
Other - Middle Name:
Other - Last Name:BARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3610 1/2 W LINDSEY ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-1881
Mailing Address - Country:US
Mailing Address - Phone:918-682-1012
Mailing Address - Fax:
Practice Address - Street 1:3610 1/2 W LINDSEY ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-1881
Practice Address - Country:US
Practice Address - Phone:918-682-1012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor