Doctor Name: | MS. SUSANNA R. PAULAY |
NPI Number: | 1033487103 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | R044358-1 |
Business Practice Address: | 125 Pond Rd Coram, NY - 117273746 |
Business Phone Number: | 5166286153 |
Business Fax Number: | 5169222098 |
Mailing Address: | 125 Pond Rd, CORAM |
State: | NY |
Postal Code: | 117273746 |
Phone Number: | 5166286153 |
Fax Number: | 5169222098 |
NPI Enumeration Date: | 12/05/2011 |
NPI Last Update Date: | 12/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | R044358-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |