Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1041C0700X | Clinical Social Worker | 5139 | ND |
Y | 1041C0700X | Clinical Social Worker | 7678596-3502 | UT |
NPI | 1003129586 |
---|---|
Provider Name | Mrs. Laurie Elkins |
First Address | San Antonio, TX 78213 |
Second Address | San Antonio, TX 78213-1844 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2010 |
Last Update Date | 28/07/2015 |