Provider Demographics
NPI:1831510452
Name:SCOTT, JANICE L (MS,RD,CSP,LD)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:L
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS,RD,CSP,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-6486
Mailing Address - Country:US
Mailing Address - Phone:214-559-7681
Mailing Address - Fax:214-559-8394
Practice Address - Street 1:2222 WELBORN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3924
Practice Address - Country:US
Practice Address - Phone:214-559-7681
Practice Address - Fax:214-559-8394
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT03228133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric