Provider Demographics
NPI:1104591601
Name:SCOTT, KRISTINA KENDRA
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:KENDRA
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 1:1020 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-4506
Mailing Address - Country:US
Mailing Address - Phone:724-371-8060
Mailing Address - Fax:
Practice Address - Street 1:2601 12TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-2429
Practice Address - Country:US
Practice Address - Phone:724-683-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health