Individual
DORIS ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
112 N HIGHWAY 5, VERSAILLES, MO 65084
(573) 378-6222
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
(573) 884-8526
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2000173546
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178920
BLUE SHIELD/BLUE CHOICE
MO
01
—
690840
HEALTHLINK
MO
Enumeration date
06/01/2006
Last updated
07/08/2007
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