Provider Demographics
NPI:1841701539
Name:ELLIOTT, JANET H (PSYD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:H
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 230376
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99523-0376
Mailing Address - Country:US
Mailing Address - Phone:907-306-0806
Mailing Address - Fax:
Practice Address - Street 1:3909 ARCTIC BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5769
Practice Address - Country:US
Practice Address - Phone:907-644-8446
Practice Address - Fax:907-644-8448
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-20
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPSYP613103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist