Basic Information
| Provider Information | |||||||||
| NPI: | 1639135130 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | CHRISTINE | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3601 S 6TH AVE # 11A-126 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857230001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207921450 | ||||||||
| FaxNumber: | 5206294707 | ||||||||
| Practice Location | |||||||||
| Address1: | 2102 N COUNTRY CLUB RD | ||||||||
| Address2: | SUITE 12 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857162831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203228211 | ||||||||
| FaxNumber: | 5203278490 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2006 | ||||||||
| LastUpdateDate: | 02/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | DA1667 | AZ | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | IZ49411 | 01 | AZ | HEATLH NET | OTHER | 748577 | 01 | AZ | AHCCCS | OTHER | AZ0901808 | 01 | AZ | BLUE CROSS BLUE SHEILD | OTHER | 0629265 | 01 | AZ | AETNA | OTHER | 150860 | 01 | AZ | ARIZONA HEAR CARE | OTHER |