Most Relevant Information
Provider Data
| NPI Number: | 1003270794 |
| Provider Name: | EDMUND JACKSON SCOTT LMFT-I, CAC-P |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/08/2016 |
| Last Updated: | 04/08/2016 |
Provider Practice Location
187 W BROAD ST STE 200
SPARTANBURG
SC
293063234
Practice Location Phone/Fax
| Phone: | 8647072801 |
| Fax: |
Provider Mailing Location
2 RUNNING DEER CT
GREER
SC
296503212
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |