Provider Demographics
NPI:1831573518
Name:SCOTT, BETTY MAXINE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:MAXINE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:MAXINE
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICENSE
Mailing Address - Street 1:4011 ARCTIC BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5701
Mailing Address - Country:US
Mailing Address - Phone:907-561-7041
Mailing Address - Fax:907-561-2349
Practice Address - Street 1:4011 ARCTIC BLVD STE 203
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5701
Practice Address - Country:US
Practice Address - Phone:907-561-7041
Practice Address - Fax:907-561-2349
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist