Provider Demographics
NPI:1053997940
Name:SCOTT, ELIZABETH JAYNE (MED)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JAYNE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MAIN ST STE 8
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1838
Mailing Address - Country:US
Mailing Address - Phone:508-797-7110
Mailing Address - Fax:774-345-4610
Practice Address - Street 1:800 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-1838
Practice Address - Country:US
Practice Address - Phone:508-797-7110
Practice Address - Fax:774-345-4610
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health