| Doctor Name: | ANGELA MARY PAULY |
| NPI Number: | 1619093838 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OTR |
| License Number: | OTR1109 |
| Business Practice Address: | 83 Airways Pl Southaven, MS - 386715885 |
| Business Phone Number: | 6623498787 |
| Business Fax Number: | |
| Mailing Address: | 1312 Gaston Dr, SOUTHAVEN |
| State: | MS |
| Postal Code: | 386717046 |
| Phone Number: | 9032933338 |
| Fax Number: | |
| NPI Enumeration Date: | 03/21/2007 |
| NPI Last Update Date: | 08/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | OTR1109 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AR |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |