Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 002740 | GA |
NPI | 1003839317 |
---|---|
Provider Name | Dr. Sigrid Y Elston |
First Address | Atlanta, GA 30305-2784 |
Second Address | Atlanta, GA 30305-2784 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10040636 | AMERIGROUP (01) | GA |
179184200A | (05) | GA |
200256766 | MENTAL HEALTH NET (01) | GA |
20026766 | PEACHSTATE (01) | GA |
52703914-001 | BLUE CROSS BLUE SHIELD (01) | GA |
N326975 | WELLCARE (01) | GA |