Healthcare Provider Details

I. General information

NPI: 1447430780
Provider Name (Legal Business Name): KATRINA DIONE ELSTON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2007
Last Update Date: 11/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 GOODYEAR AVE
GADSDEN AL
35903-1106
US

IV. Provider business mailing address

901 GOODYEAR AVE
GADSDEN AL
35903-1106
US

V. Phone/Fax

Practice location:
  • Phone: 256-492-7800
  • Fax: 256-494-5536
Mailing address:
  • Phone: 256-492-7800
  • Fax: 256-494-5536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: