Basic Information
| Provider Information | |||||||||
| NPI: | 1902899107 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELLIOT | ||||||||
| FirstName: | ELLIE | ||||||||
| MiddleName: | S.R. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD., BCPP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 E, 24TH STREET | ||||||||
| Address2: | CENTER FOR BEHAVIORAL MEDICINE | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165127477 | ||||||||
| FaxNumber: | 8165127486 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E, 24TH STREET | ||||||||
| Address2: | CENTER FOR BEHAVIORAL MEDICINE | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165127477 | ||||||||
| FaxNumber: | 8165127486 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2005 | ||||||||
| LastUpdateDate: | 02/14/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1300X | PH045055 | MO | Y | Pharmacy Service Providers | Pharmacist | Psychiatric |
No ID Information.