Doctor Name: | MR. ALLEN ELLIOTT |
NPI Number: | 1134372014 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | G11428 |
Business Practice Address: | 96 Harry S Truman Dr Upper Marlboro, MD - 207741000 |
Business Phone Number: | 3013245009 |
Business Fax Number: | |
Mailing Address: | 4614 Snowflower Blvd, OXON HILL |
State: | MD |
Postal Code: | 207453400 |
Phone Number: | 2024894115 |
Fax Number: | |
NPI Enumeration Date: | 10/23/2008 |
NPI Last Update Date: | 10/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | G11428 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |