Healthcare Provider Details

I. General information

NPI: 1013158211
Provider Name (Legal Business Name): ERIN CHRISTINE ELLIOTT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERIN CHRISTINE AHOLT PH.D.

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 04/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT RD MAILCODE 116
DECATUR GA
30033-4004
US

IV. Provider business mailing address

1670 CLAIRMONT RD MAILCODE 116
DECATUR GA
30033-4004
US

V. Phone/Fax

Practice location:
  • Phone: 404-321-6111
  • Fax: 404-329-4622
Mailing address:
  • Phone: 404-321-6111
  • Fax: 404-329-4622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: