Individual
DEMETRIUS ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3707 E SOUTHERN AVE, MESA, AZ 85206-2569
(919) 909-1922
Mailing address
132 PAY DAY LN, CLAYTON, NC 27520-4418
(919) 909-1922
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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