Provider Demographics
NPI:1316342595
Name:SCOTT, KENDRA MARIE
Entity type:Individual
Prefix:MS
First Name:KENDRA
Middle Name:MARIE
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 1:10697 W CENTENNIAL PKWY APT 2021
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-1507
Mailing Address - Country:US
Mailing Address - Phone:702-241-3888
Mailing Address - Fax:
Practice Address - Street 1:10697 W CENTENNIAL PKWY APT 2021
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-1507
Practice Address - Country:US
Practice Address - Phone:702-241-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health