Provider Demographics
NPI:1326586108
Name:SCOTT, AMY LEE (BSN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LEE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 VIA COLINAS
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-5052
Mailing Address - Country:US
Mailing Address - Phone:805-791-1960
Mailing Address - Fax:
Practice Address - Street 1:1023 VIA COLINAS
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-5052
Practice Address - Country:US
Practice Address - Phone:805-791-1960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA681084163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant