Provider Demographics
NPI:1811123946
Name:SCOTT, ROSILIND WILSON (SLP)
Entity type:Individual
Prefix:
First Name:ROSILIND
Middle Name:WILSON
Last Name:SCOTT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 PRINCESA DR
Mailing Address - Street 2:
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037-9525
Mailing Address - Country:US
Mailing Address - Phone:318-949-5148
Mailing Address - Fax:
Practice Address - Street 1:820 PRINCESA DR
Practice Address - Street 2:
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-9525
Practice Address - Country:US
Practice Address - Phone:318-949-5148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist