| Doctor Name: | MS. PAULA ELLEN SISTARE |
| NPI Number: | 1699827634 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, NCC |
| License Number: | 001272 |
| Business Practice Address: | 41 Hartford Ave. Granby, CT - 060350206 |
| Business Phone Number: | 8608448998 |
| Business Fax Number: | 8606538077 |
| Mailing Address: | 41hartfod Avenue, P. O. Box 206 GRANBY |
| State: | CT |
| Postal Code: | 060350206 |
| Phone Number: | 8608448998 |
| Fax Number: | 8606538077 |
| NPI Enumeration Date: | 01/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 001272 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |