Provider Demographics
NPI:1740764687
Name:ELKINS, KAYLIN M
Entity Type:Individual
Prefix:
First Name:KAYLIN
Middle Name:M
Last Name:ELKINS
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 1:1001 S BRADFORD ST STE 9
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-4153
Mailing Address - Country:US
Mailing Address - Phone:302-526-1959
Mailing Address - Fax:302-526-2182
Practice Address - Street 1:1001 S BRADFORD ST STE 9
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-4153
Practice Address - Country:US
Practice Address - Phone:302-526-1959
Practice Address - Fax:302-526-2182
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DERBT-18-65510106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician