Provider Demographics
NPI:1174044168
Name:WILSON-HOWELL, PAULA (PSYD; LAC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:WILSON-HOWELL
Suffix:
Gender:F
Credentials:PSYD; LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1082 SHADOWLAWN DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1747
Mailing Address - Country:US
Mailing Address - Phone:917-771-6172
Mailing Address - Fax:
Practice Address - Street 1:2130 MILLBURN AVE STE D2
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3749
Practice Address - Country:US
Practice Address - Phone:917-771-6172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00367900103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling