Provider Demographics
NPI:1831239243
Name:SCOTT, WILLIAM BRISBIN (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRISBIN
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 BEALL AVE
Mailing Address - Street 2:COLLEGE OF WOOSTER PSYCHOLOGY DEPARTMENT
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2393
Mailing Address - Country:US
Mailing Address - Phone:330-280-4165
Mailing Address - Fax:
Practice Address - Street 1:1189 BEALL AVE
Practice Address - Street 2:COLLEGE OF WOOSTER PSYCHOLOGY DEPARTMENT
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2393
Practice Address - Country:US
Practice Address - Phone:330-280-4165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3675103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical