Provider Demographics
NPI:1285497511
Name:SCOTT, JAYDEN (AAS-HIS)
Entity type:Individual
Prefix:
First Name:JAYDEN
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:AAS-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3761 N. STATE HWY H
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803
Mailing Address - Country:US
Mailing Address - Phone:417-468-8382
Mailing Address - Fax:
Practice Address - Street 1:3761 N. STATE HWY H
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-6580
Practice Address - Country:US
Practice Address - Phone:417-840-8207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024000377237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist