Provider Demographics
NPI:1225567597
Name:PAUL-CONSTANTIN, VINCENTIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:VINCENTIA
Middle Name:
Last Name:PAUL-CONSTANTIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 S LEE ST STE 200A
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-5796
Mailing Address - Country:US
Mailing Address - Phone:340-473-5146
Mailing Address - Fax:
Practice Address - Street 1:4330 S LEE ST STE 200A
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-5796
Practice Address - Country:US
Practice Address - Phone:340-473-5146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities