Provider Demographics
NPI:1891987095
Name:ELLIOT, GAIL KATHARINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:KATHARINE
Last Name:ELLIOT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:FURLONG
Mailing Address - State:PA
Mailing Address - Zip Code:18925-1032
Mailing Address - Country:US
Mailing Address - Phone:215-794-3884
Mailing Address - Fax:215-794-3386
Practice Address - Street 1:73 VALLEY DR
Practice Address - Street 2:
Practice Address - City:FURLONG
Practice Address - State:PA
Practice Address - Zip Code:18925-1032
Practice Address - Country:US
Practice Address - Phone:215-794-3884
Practice Address - Fax:215-794-3386
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003547L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist