| Doctor Name: | MR. PAUL MICHAEL PONTOSKI |
| NPI Number: | 1083834865 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS, LPC |
| License Number: | PC002078 |
| Business Practice Address: | 4115 Forest Inn Palmerton, PA - 18071 |
| Business Phone Number: | 6108242404 |
| Business Fax Number: | |
| Mailing Address: | 534 Oak Ln, TAMAQUA |
| State: | PA |
| Postal Code: | 182525606 |
| Phone Number: | 5703868082 |
| Fax Number: | |
| NPI Enumeration Date: | 04/26/2007 |
| NPI Last Update Date: | 05/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | PC002078 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |