Provider Demographics
NPI:1336753060
Name:SCOTT, SIDNEY LEIGH (CF-SLP)
Entity Type:Individual
Prefix:
First Name:SIDNEY
Middle Name:LEIGH
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 285
Mailing Address - Street 2:
Mailing Address - City:HAMPTON FALLS
Mailing Address - State:NH
Mailing Address - Zip Code:03844-0285
Mailing Address - Country:US
Mailing Address - Phone:603-918-1298
Mailing Address - Fax:
Practice Address - Street 1:144 NEWBURYPORT TPKE STE A8
Practice Address - Street 2:
Practice Address - City:ROWLEY
Practice Address - State:MA
Practice Address - Zip Code:01969-2132
Practice Address - Country:US
Practice Address - Phone:603-918-1298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3080298Medicaid