Individual
TRACI DANIELLE SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2211 BURPEE DR, JACKSONVILLE, FL 32210-3728
(904) 382-6261
Mailing address
PO BOX 14037, JACKSONVILLE, FL 32238-1037
(904) 382-6261
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S300804885150
DRIVER LICENSE
FL
Enumeration date
03/21/2022
Last updated
03/21/2022
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