Provider Demographics
NPI:1558586024
Name:ELMORE, LINNIE (MFT)
Entity Type:Individual
Prefix:MR
First Name:LINNIE
Middle Name:
Last Name:ELMORE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 MARLTON PIKE E STE K57
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-4107
Mailing Address - Country:US
Mailing Address - Phone:856-261-0030
Mailing Address - Fax:
Practice Address - Street 1:1930 MARLTON PIKE E STE K57
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-4107
Practice Address - Country:US
Practice Address - Phone:856-261-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist