Provider Demographics
NPI:1023218385
Name:PALOS, ARRIA LEE
Entity Type:Individual
Prefix:MRS
First Name:ARRIA
Middle Name:LEE
Last Name:PALOS
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:PO BOX 351
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:OK
Mailing Address - Zip Code:73717-0351
Mailing Address - Country:US
Mailing Address - Phone:580-327-0565
Mailing Address - Fax:
Practice Address - Street 1:429 BARNES STREET
Practice Address - Street 2:
Practice Address - City:ALVA
Practice Address - State:OK
Practice Address - Zip Code:73717-0351
Practice Address - Country:US
Practice Address - Phone:580-327-0565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker