| Doctor Name: | SCOTT W LANDIS |
| NPI Number: | 1023216371 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 720 Wood St Eureka, CA - 955014413 |
| Business Phone Number: | 7072682990 |
| Business Fax Number: | |
| Mailing Address: | 4525 Kjer Rd, Apt. #b MCKINLEYVILLE |
| State: | CA |
| Postal Code: | 955198020 |
| Phone Number: | 7078400494 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2007 |
| NPI Last Update Date: | 07/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |