Provider Demographics
NPI:1902990575
Name:CHILTON, ARLEEN A (BS)
Entity Type:Individual
Prefix:MS
First Name:ARLEEN
Middle Name:A
Last Name:CHILTON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404
Mailing Address - Country:US
Mailing Address - Phone:850-747-5411
Mailing Address - Fax:850-747-5583
Practice Address - Street 1:700 W 23RD ST BLDG E40
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3936
Practice Address - Country:US
Practice Address - Phone:850-381-9624
Practice Address - Fax:850-747-5583
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL766965800Medicaid