Provider Demographics
NPI:1356725634
Name:SCOTT, BRENDA A
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:A
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:A
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSAC, LAC
Mailing Address - Street 1:2 WILLIAM J HTS
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6134
Mailing Address - Country:US
Mailing Address - Phone:617-678-8812
Mailing Address - Fax:
Practice Address - Street 1:2 WILLIAM J HTS
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6134
Practice Address - Country:US
Practice Address - Phone:617-678-8812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA265039171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA265039OtherMA BOARD OF REGISTRATION IN MEDICINE
139198OtherNATIONAL CERTIFICATION COMMISSION FOR ACUPUNCTURE & ORIENTAL MEDICINE