Provider Demographics
NPI:1538490834
Name:HARLAN DREWEL, ELENA THERESSA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:THERESSA
Last Name:HARLAN DREWEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:300 PORTLAND ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6569
Mailing Address - Country:US
Mailing Address - Phone:573-884-6052
Mailing Address - Fax:573-884-1151
Practice Address - Street 1:300 PORTLAND ST
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6569
Practice Address - Country:US
Practice Address - Phone:573-884-6052
Practice Address - Fax:573-884-1151
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2009031278103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist