Basic Information
| Provider Information | |||||||||
| NPI: | 1518342658 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOSNER | ||||||||
| FirstName: | PAULA | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | BA, DP-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MOSHER KNOX | ||||||||
| OtherFirstName: | PAULA | ||||||||
| OtherMiddleName: | R | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8212 N JENNINGS RD | ||||||||
| Address2: | |||||||||
| City: | MOUNT MORRIS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484588248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8106875100 | ||||||||
| FaxNumber: | 8106870520 | ||||||||
| Practice Location | |||||||||
| Address1: | 1110 ELDON BAKER DR | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485071923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102322766 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2015 | ||||||||
| LastUpdateDate: | 12/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 6401016243 | MI | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.