Basic Information
| Provider Information | |||||||||
| NPI: | 1306972419 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POWERS | ||||||||
| FirstName: | PAULA | ||||||||
| MiddleName: | JEAN | ||||||||
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| Credential: | M.S.LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 WILDER RD | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014536650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783437081 | ||||||||
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| Practice Location | |||||||||
| Address1: | 45 SUMMER ST | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014533228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9785346116 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 303001 | MA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.