Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1104043918 |
---|---|
Provider Name | Ms. Linda Elaine Elliott |
First Address | Sierra Vista, AZ 85635-5078 |
Second Address | Sierra Vista, AZ 85635-5078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 08/07/2007 |