Provider Demographics
NPI:1265210280
Name:ARRENDONDO, RAYMOND (BS)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:ARRENDONDO
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6014 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3233
Mailing Address - Country:US
Mailing Address - Phone:414-483-8671
Mailing Address - Fax:414-483-8672
Practice Address - Street 1:6014 W MADISON ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-3233
Practice Address - Country:US
Practice Address - Phone:414-483-8671
Practice Address - Fax:414-483-8672
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health