Provider Demographics
NPI:1124210737
Name:ELMORE, DONNA J (MS)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:J
Last Name:ELMORE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 E 51ST ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135
Mailing Address - Country:US
Mailing Address - Phone:918-764-9098
Mailing Address - Fax:319-856-8426
Practice Address - Street 1:5525 E 51ST ST
Practice Address - Street 2:SUITE 210
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135
Practice Address - Country:US
Practice Address - Phone:918-764-9098
Practice Address - Fax:319-856-8426
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health