Individual
LAUREN SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
770 RITCHIE HWY # 21, SEVERNA PARK, MD 21146-4149
(313) 749-8239
Mailing address
770 RITCHIE HWY # 21, SEVERNA PARK, MD 21146-4149
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001788
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000026163
BOARD OF CERTIFICATION
—
01
—
2601001788
STATE OF MICHIGAN ATHLETIC TRAINING LICENSE
MI
Enumeration date
01/23/2018
Last updated
04/02/2020
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