Provider Demographics
NPI:1811252323
Name:RIOS, ANDREA DAWN (CDA)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:DAWN
Last Name:RIOS
Suffix:
Gender:F
Credentials:CDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 SW 55TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73119-5417
Mailing Address - Country:US
Mailing Address - Phone:405-305-5221
Mailing Address - Fax:
Practice Address - Street 1:4209 NW 23RD ST STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2645
Practice Address - Country:US
Practice Address - Phone:405-917-1709
Practice Address - Fax:405-917-1713
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst