Provider Demographics
NPI:1780424457
Name:SCROGGINS, PENNY DENISE
Entity type:Individual
Prefix:MS
First Name:PENNY
Middle Name:DENISE
Last Name:SCROGGINS
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 1:1051 19TH ST UNIT 306
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-1213
Mailing Address - Country:US
Mailing Address - Phone:515-943-7285
Mailing Address - Fax:
Practice Address - Street 1:1051 19TH ST UNIT 306
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1213
Practice Address - Country:US
Practice Address - Phone:515-943-7285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical