Provider Demographics
NPI:1962387092
Name:SCOTT, MADISON LYNN (CERTBBM)
Entity type:Individual
Prefix:MS
First Name:MADISON
Middle Name:LYNN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:CERTBBM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 GRAY RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-9104
Mailing Address - Country:US
Mailing Address - Phone:810-287-3331
Mailing Address - Fax:
Practice Address - Street 1:2350 WASHTENAW AVE STE 3
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4526
Practice Address - Country:US
Practice Address - Phone:810-279-0880
Practice Address - Fax:810-776-3038
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist