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General NPI Number Information
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NPI Number | 1760701932
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Entity Type | Individual
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Provider Name | MRS. CORINNE YVONNE ELKINS
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Gender | Female
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 300 BLUFF AVE
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City | POTEAU
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State | OK
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Zip | 74953-5008
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Country | US
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Telephone | 918-721-5731
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Fax |
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Provider Business Mailing Address
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Address Line | 300 BLUFF AVE
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City | POTEAU
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State | OK
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Zip | 74953-5008
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Country | US
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Telephone | 918-721-5731
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2611-B
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License Number State | AR
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