Provider Demographics
NPI:1013031293
Name:HOUCK, PAULA B (PHD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:B
Last Name:HOUCK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 WOODPORT RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2424
Mailing Address - Country:US
Mailing Address - Phone:973-702-7071
Mailing Address - Fax:
Practice Address - Street 1:48 WOODPORT RD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2424
Practice Address - Country:US
Practice Address - Phone:973-702-7071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4168103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ797768000OtherMAGELLAN