Provider Demographics
NPI:1477219871
Name:ELLIOTT, MARIA ANNETTE
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ANNETTE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 S POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-7200
Mailing Address - Country:US
Mailing Address - Phone:913-274-6608
Mailing Address - Fax:
Practice Address - Street 1:531 S POPLAR ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-7200
Practice Address - Country:US
Practice Address - Phone:913-274-6608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician