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General NPI Number Information
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NPI Number | 1588817969
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Entity Type | Individual
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Provider Name | CYNTHIA MARIE ELKO PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 1275B W PULASKI HWY
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City | ELKTON
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State | MD
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Zip | 21921-4719
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Country | US
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Telephone | 410-620-7161
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Fax | 410-620-7168
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Provider Business Mailing Address
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Address Line | 44 CORNWALL DR
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City | NEWARK
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State | DE
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Zip | 19711-7734
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Country | US
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Telephone | 302-229-2110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 04433
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License Number State | MD
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