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1134675051
KEITH SCOTT
SMITHTOWN, NY
NPI
1134675051
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 30879)
Enumeration Date
2016-08-31
Last Update Date
2016-08-31
Business Address
-- KEITH SCOTT CASAC-T
11 ROUTE 111
SMITHTOWN, NY 11787-3754
Phone number: 631-920-8609
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Mailing Address
-- KEITH SCOTT CASAC-T
2 BLUFF ROAD
SAINT JAMES, NY 11780
Phone number: 631-880-2444
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