Provider Demographics
NPI:1033423587
Name:GREEN, PAULA JANE
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:JANE
Last Name:GREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 E MERRIMACK ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1900
Mailing Address - Country:US
Mailing Address - Phone:978-453-6800
Mailing Address - Fax:978-458-1428
Practice Address - Street 1:77 E MERRIMACK ST STE 1
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1900
Practice Address - Country:US
Practice Address - Phone:978-453-6800
Practice Address - Fax:978-458-1428
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health