Individual
JESSICA SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
123 S BROAD ST STE 1833, PHILADELPHIA, PA 19109-1026
(610) 637-6106
Mailing address
4803 REGENT ST, PHILADELPHIA, PA 19143-3425
(610) 637-6106
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7218276
TIMS
PA
Enumeration date
10/03/2022
Last updated
10/03/2022
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