Individual
SHIRLEY SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 HAAG DR, WARNER ROBINS, GA 31093
(305) 354-6470
Mailing address
858 WYNBROKE PARKWAY, STONE MOUNTAIN, GA 30087
(305) 354-6470
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
GA
Other
Enumeration date
09/19/2017
Last updated
03/11/2026
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