Individual
ANDREA ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC, SAP
Contact information
Practice address
320 SIOUX ST, KELLER, TX 76248-2445
(817) 337-4518
Mailing address
320 SIOUX ST, KELLER, TX 76248-2445
(817) 337-4518
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10843
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
20370
TX
Other
Enumeration date
03/21/2014
Last updated
03/21/2014
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