Provider Demographics
NPI:1336534346
Name:ELDER, EMILY MARIE (PHD, HSPP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:ELDER
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7174 HARTFORD PIKE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IN
Mailing Address - Zip Code:47001-9206
Mailing Address - Country:US
Mailing Address - Phone:419-681-0710
Mailing Address - Fax:
Practice Address - Street 1:401 WEST EADS PARKWAY
Practice Address - Street 2:SUITE 450
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47205
Practice Address - Country:US
Practice Address - Phone:812-532-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043050A103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling