Provider Demographics
NPI:1871738005
Name:BLANKS, ELVA ELAINE (PHD)
Entity type:Individual
Prefix:DR
First Name:ELVA
Middle Name:ELAINE
Last Name:BLANKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ELVA
Other - Middle Name:ELAINE
Other - Last Name:HULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3295 N DRINKWATER BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6492
Mailing Address - Country:US
Mailing Address - Phone:602-751-6335
Mailing Address - Fax:480-820-0239
Practice Address - Street 1:3295 N DRINKWATER BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6492
Practice Address - Country:US
Practice Address - Phone:602-751-6335
Practice Address - Fax:480-820-0239
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4005103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling