Provider Demographics
NPI:1649480344
Name:COREY, ELAINE DANEKER (PHD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:DANEKER
Last Name:COREY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ELAINE
Other - Middle Name:PAMELA
Other - Last Name:DANEKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:7600 OSLER DR STE 211
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7701
Mailing Address - Country:US
Mailing Address - Phone:410-337-8883
Mailing Address - Fax:
Practice Address - Street 1:1850 YORK RD STE K
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-5122
Practice Address - Country:US
Practice Address - Phone:410-760-9079
Practice Address - Fax:410-760-1121
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04172103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical