Provider Demographics
NPI:1467273284
Name:PALAZZOLO, LIA (MA, MS)
Entity type:Individual
Prefix:
First Name:LIA
Middle Name:
Last Name:PALAZZOLO
Suffix:
Gender:X
Credentials:MA, MS
Other - Prefix:
Other - First Name:LP
Other - Middle Name:
Other - Last Name:PALAZZOLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, MS
Mailing Address - Street 1:1 SERENITY LN
Mailing Address - Street 2:
Mailing Address - City:COBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97408-9350
Mailing Address - Country:US
Mailing Address - Phone:541-687-1110
Mailing Address - Fax:
Practice Address - Street 1:1 SERENITY LN
Practice Address - Street 2:
Practice Address - City:COBURG
Practice Address - State:OR
Practice Address - Zip Code:97408-9350
Practice Address - Country:US
Practice Address - Phone:541-687-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health