Provider Demographics
NPI:1124308317
Name:SCOTT, FELICIA DENISE (CNA)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:DENISE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9020 MILL VALLEY CIR APT 237
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-4824
Mailing Address - Country:US
Mailing Address - Phone:817-363-6051
Mailing Address - Fax:
Practice Address - Street 1:9020 MILL VALLEY CIR APT 237
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-4824
Practice Address - Country:US
Practice Address - Phone:817-363-6051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA08751174103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst