Provider Demographics
NPI:1982004743
Name:HINKLE, ELAINE N (BSL)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:N
Last Name:HINKLE
Suffix:
Gender:F
Credentials:BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 HIGHLAND DR
Mailing Address - Street 2:P.O. BOX 597
Mailing Address - City:MOUNTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17554-1232
Mailing Address - Country:US
Mailing Address - Phone:717-285-7121
Mailing Address - Fax:717-285-0616
Practice Address - Street 1:2330 VARTAN WAY
Practice Address - Street 2:SUITE 204
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9763
Practice Address - Country:US
Practice Address - Phone:717-920-9434
Practice Address - Fax:717-920-9197
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001989103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst