| Doctor Name: | MS. PAMELA JO ELLIOTT |
| NPI Number: | 1841200904 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC NCC |
| License Number: | 180004957 |
| Business Practice Address: | 1820 N Sterling Ave West Peoria, IL - 616046433 |
| Business Phone Number: | 3092123606 |
| Business Fax Number: | 3127894373 |
| Mailing Address: | 1820 N Sterling Ave, WEST PEORIA |
| State: | IL |
| Postal Code: | 616046433 |
| Phone Number: | 3092123606 |
| Fax Number: | 3127894373 |
| NPI Enumeration Date: | 08/09/2006 |
| NPI Last Update Date: | 04/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 180004957 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |