Doctor Name: | DR. GAIL ELMORE |
NPI Number: | 1417365628 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH. D. |
License Number: | 1130 |
Business Practice Address: | 11629 Broad River Rd Chapin, SC - 290368549 |
Business Phone Number: | 8033178776 |
Business Fax Number: | |
Mailing Address: | 11629 Broad River Rd, CHAPIN |
State: | SC |
Postal Code: | 290368549 |
Phone Number: | 8033178776 |
Fax Number: | |
NPI Enumeration Date: | 07/31/2014 |
NPI Last Update Date: | 07/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 1130 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |