Provider Demographics
NPI:1518331990
Name:BRIZUELA, ELENA PATRICIA
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:PATRICIA
Last Name:BRIZUELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 S CANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-4318
Mailing Address - Country:US
Mailing Address - Phone:931-490-1580
Mailing Address - Fax:
Practice Address - Street 1:230 E JAMES CAMPBELL BLVD
Practice Address - Street 2:STE. 113
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4597
Practice Address - Country:US
Practice Address - Phone:931-490-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-22
Last Update Date:2015-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor