Individual
MRS. SUZANNE HOLT ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
567
WV
103TS0200X
School Psychologist
Primary
21015
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164229000
—
WV
Enumeration date
10/02/2006
Last updated
10/12/2007
Update your record
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