Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY1888 | DC |
N | 103TC0700X | Clinical Psychologist | PSY1888 | DC |
N | 102L00000X | Psychologist | PSY1888 | DC |
N | 103T00000X | Psychologist | PSY1888 | DC |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY1888 | DC |
N | 103G00000X | Clinical Psychologist | PSY1888 | DC |
N | 103TC0700X | Clinical Psychologist | PSY1888 | DC |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY1888 | DC |
N | 103TH0004X | Health Psychologist | PSY1888 | DC |
N | 103TH0100X | Health Service | PSY1888 | DC |
N | 103TM1800X | Intellectual & Developmental Disabilities | PSY1888 | DC |
NPI | 1053530659 |
---|---|
Provider Name | Teresa Kay Elliott |
First Address | Washington, DC 20011-6926 |
Second Address | Washington, DC 20011-6926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 08/07/2007 |