| Doctor Name: | DR. SCOTT CAMBURN STORM |
| NPI Number: | 1013002336 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYD |
| License Number: | 33327 |
| Business Practice Address: | 3814 Sherwood Way San Angelo, TX - 769013539 |
| Business Phone Number: | 3256175970 |
| Business Fax Number: | 3256175307 |
| Mailing Address: | 3814 Sherwood Way, SAN ANGELO |
| State: | TX |
| Postal Code: | 769013539 |
| Phone Number: | 3256175970 |
| Fax Number: | 3256175307 |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 12/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 33327 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |