Provider Demographics
NPI:1487748638
Name:SCOTT, ROXANNE I (PHD)
Entity type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:I
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 W PIONEER DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-7122
Mailing Address - Country:US
Mailing Address - Phone:972-254-2215
Mailing Address - Fax:
Practice Address - Street 1:1425 W PIONEER DR
Practice Address - Street 2:SUITE 260
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-7122
Practice Address - Country:US
Practice Address - Phone:972-254-2215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004568106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist