Provider Demographics
NPI:1063657195
Name:WANG, PAULA L (LPC)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:L
Last Name:WANG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 LENORE DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-2397
Mailing Address - Country:US
Mailing Address - Phone:503-304-1705
Mailing Address - Fax:
Practice Address - Street 1:1029 RIVER RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-3242
Practice Address - Country:US
Practice Address - Phone:503-972-0235
Practice Address - Fax:541-631-5114
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional