Provider Demographics
NPI:1699846477
Name:ELKINGTON-FOWLER, MARIA KOSTER (M COUNS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:KOSTER
Last Name:ELKINGTON-FOWLER
Suffix:
Gender:F
Credentials:M COUNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 AUTUMN GRASS ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-8667
Mailing Address - Country:US
Mailing Address - Phone:702-433-6593
Mailing Address - Fax:
Practice Address - Street 1:3075 E FLAMINGO RD
Practice Address - Street 2:SUITE 108
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7483
Practice Address - Country:US
Practice Address - Phone:702-496-7503
Practice Address - Fax:702-486-7522
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health