Provider Demographics
NPI:1164705620
Name:MORTILLARO, PAULA FRANCES (MA)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:FRANCES
Last Name:MORTILLARO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:FRANCES
Other - Last Name:SPECHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1041 W BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-4342
Mailing Address - Country:US
Mailing Address - Phone:610-933-8110
Mailing Address - Fax:610-933-7451
Practice Address - Street 1:1041 W BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4342
Practice Address - Country:US
Practice Address - Phone:610-933-8110
Practice Address - Fax:610-933-7451
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health