Provider Demographics
NPI:1114200177
Name:PAULEY, RHONDA LYNN (M A)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:LYNN
Last Name:PAULEY
Suffix:
Gender:F
Credentials:M A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 MACCORKLE AVE SW STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-1331
Mailing Address - Country:US
Mailing Address - Phone:304-348-1269
Mailing Address - Fax:304-348-1017
Practice Address - Street 1:1418 MACCORKLE AVE SW STE A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1331
Practice Address - Country:US
Practice Address - Phone:304-348-1269
Practice Address - Fax:304-348-1017
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1033103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical