| Doctor Name: | MICHELLE SCOGGINS |
| NPI Number: | 1417318569 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 103T00000X |
| Business Practice Address: | 23370 Road 22 Chowchilla, CA - 936108504 |
| Business Phone Number: | 5596655531 |
| Business Fax Number: | |
| Mailing Address: | 2229 E Brandywine Ln, FRESNO |
| State: | CA |
| Postal Code: | 937204659 |
| Phone Number: | 2097561915 |
| Fax Number: | |
| NPI Enumeration Date: | 03/17/2016 |
| NPI Last Update Date: | 03/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 103T00000X |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |