Doctor Name: | FRED ELMENDORF |
NPI Number: | 1720122039 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | R.N. |
License Number: | 35884 |
Business Practice Address: | 413 Spring St Chattanooga, TN - 374053848 |
Business Phone Number: | 4237562740 |
Business Fax Number: | |
Mailing Address: | 4913 Orchard Dr, APISON |
State: | TN |
Postal Code: | 373029523 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 35884 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |