Individual
SHANNON E SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11107 WURZBACH RD, SUITE 403, SAN ANTONIO, TX 78230-2500
(210) 697-1866
(210) 697-1867
Mailing address
11107 WURZBACH RD, SUITE 403, SAN ANTONIO, TX 78230-2500
(210) 697-1866
(210) 697-1867
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
23728
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00D50B
BLUE CROSS BLUE SHIELD
TX
05
—
032647201
—
TX
01
—
205136900
TEXAS WORKER'S COMP
TX
01
—
23728
STATE LICENSE
TX
Enumeration date
12/04/2006
Last updated
05/10/2010
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