Provider Demographics
NPI:1679344014
Name:ARRIONDO, ELAINA MARIE (AMFT)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:MARIE
Last Name:ARRIONDO
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 WILMA RUDOLPH BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-5824
Mailing Address - Country:US
Mailing Address - Phone:208-304-8785
Mailing Address - Fax:
Practice Address - Street 1:2515 WILMA RUDOLPH BLVD STE 109
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5824
Practice Address - Country:US
Practice Address - Phone:931-330-0695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9737106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist