| Doctor Name: | MR. FRED HENRY PAULI |
| NPI Number: | 1568691574 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.M.H.C., L.P.C. |
| License Number: | LPC001249 |
| Business Practice Address: | 422 5th Ave N Jacksonville Beach, FL - 322505614 |
| Business Phone Number: | 9042462457 |
| Business Fax Number: | 9042462152 |
| Mailing Address: | Po Box 51153, JACKSONVILLE BEACH |
| State: | FL |
| Postal Code: | 322401153 |
| Phone Number: | 9042462457 |
| Fax Number: | 9042462152 |
| NPI Enumeration Date: | 07/11/2009 |
| NPI Last Update Date: | 07/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | LPC001249 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |