Provider Demographics
NPI:1033216361
Name:DEPORTER, ELFI SILVA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELFI
Middle Name:SILVA
Last Name:DEPORTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ELFI
Other - Middle Name:SILVA
Other - Last Name:PAVIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:270 S PLANER MILL RD
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-3142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1585TH STREET (BLDG 285)
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71459
Practice Address - Country:US
Practice Address - Phone:337-531-3922
Practice Address - Fax:337-531-3760
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23714103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical