Provider Demographics
NPI:1295442051
Name:SCOTT, TAMIKA L
Entity type:Individual
Prefix:
First Name:TAMIKA
Middle Name:L
Last Name:SCOTT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 E 112TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1319
Mailing Address - Country:US
Mailing Address - Phone:216-396-8998
Mailing Address - Fax:
Practice Address - Street 1:1359 E 112TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1319
Practice Address - Country:US
Practice Address - Phone:216-396-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty