Elliott, Gary W.

Elliott, Gary W. is an sole proprietor health care provider with primary practice located at 314 W Catalpa Suite E, Mishawaka IN 46545. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Elliott, Gary W. can be contacted via phone (574) 254-1700.

Contact Information

Primary practice address
314 W Catalpa Suite E Mishawaka IN 46545
Phone: (574) 254-1700
Fax: (574) 254-2930
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 20010470A Indiana
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20010470A Indiana

Profile Details

NPI number 1518956648
LBN Legal business name Elliott, Gary W.
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2005
Last updated Jan 10th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518956648 NPPES
Indiana Other 1844001 OAKLAWN PSYCHIATRIC CENTE

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