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Individual
MR. JEFFREY BRYAN ELLIOTT
Active
Individual
MR. JEFFREY BRYAN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.C.
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-10063
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-10173
AZ
Other
Enumeration date
07/30/2007
Last updated
07/30/2007
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