Provider Demographics
NPI:1356740484
Name:SCOTT, AYANA
Entity type:Individual
Prefix:
First Name:AYANA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 NEW BROOKLYN ERIAL RD
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-3284
Mailing Address - Country:US
Mailing Address - Phone:856-537-2308
Mailing Address - Fax:856-435-6074
Practice Address - Street 1:1095 NEW BROOKLYN ERIAL RD
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-3284
Practice Address - Country:US
Practice Address - Phone:856-537-2308
Practice Address - Fax:856-435-6074
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health