Individual
JACQUELYN R SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8690 BROADWAY STE A, MERRILLVILLE, IN 46410-7034
(219) 750-9600
Mailing address
500 E 53RD AVE, MERRILLVILLE, IN 46410-1537
(219) 484-1975
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.112519
IL
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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