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NPI Code Detail

MEDICARE: ARELIOUS RICHARDSON

MEDICARE: ARELIOUS RICHARDSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1629962535
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARELIOUS RICHARDSON
Provider Business Mailing Address
First Line : 2029 S SHERIDAN RD
Second Line :
City : TULSA
State : OK
Zip : 74112-7309
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2029 S SHERIDAN RD
Second Line :
City : TULSA
State : OK
Zip : 74112-7309
Country : US
Telephone Number : 918-587-9471
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2025
Last Update Date : 06/05/2025

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