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NPI 1902172968

NPI 1902172968 : AILEEN PALACIOS LMSW : PHARR, TX

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General NPI Number Information
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    NPI Number           |    1902172968
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    Entity Type          |    Individual 
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    Provider Name        |    AILEEN PALACIOS LMSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/23/2012
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    Last Update Date     |    03/23/2012
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Provider Practice Location Address
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    Address Line         |    5510 N CAGE BLVD STE C 
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    City                 |    PHARR
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    State                |    TX
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    Zip                  |    78577-1813
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    Country              |    US
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    Telephone            |    956-787-7111
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    Fax                  |    956-781-2233
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Provider Business Mailing Address
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    Address Line         |    5510 N CAGE BLVD STE C 
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    City                 |    PHARR
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    State                |    TX
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    Zip                  |    78577-1813
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    Country              |    US
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    Telephone            |    956-787-7111
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    Fax                  |    956-781-2233
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    55216
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    License Number State |    TX
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