Provider Demographics
NPI:1831355726
Name:AVALOS, PATRICIA A (MAED)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:A
Last Name:AVALOS
Suffix:
Gender:F
Credentials:MAED
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 223
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653-0223
Mailing Address - Country:US
Mailing Address - Phone:520-616-0168
Mailing Address - Fax:
Practice Address - Street 1:3505 W MILTON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-3621
Practice Address - Country:US
Practice Address - Phone:520-908-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool