Provider Demographics
NPI:1538943733
Name:SCOTT, VALENCIA NASHAWN
Entity type:Individual
Prefix:
First Name:VALENCIA
Middle Name:NASHAWN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 ELM ST APT 2509
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-2905
Mailing Address - Country:US
Mailing Address - Phone:334-868-1819
Mailing Address - Fax:
Practice Address - Street 1:2021 LAKESIDE BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4301
Practice Address - Country:US
Practice Address - Phone:214-257-8376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist