Provider Demographics
NPI:1760701932
Name:ELKINS, CORINNE YVONNE
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:YVONNE
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 1:300 BLUFF AVE
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-5008
Mailing Address - Country:US
Mailing Address - Phone:918-721-5731
Mailing Address - Fax:
Practice Address - Street 1:300 BLUFF AVE
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-5008
Practice Address - Country:US
Practice Address - Phone:918-721-5731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2611-B104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker