Provider Demographics
NPI:1326133414
Name:JORNE, PAULA M (PHD LPC)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:M
Last Name:JORNE
Suffix:
Gender:F
Credentials:PHD LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2075 W BIG BEAVER RD STE 520
Mailing Address - Street 2:BIRMINGHAM MAPLE CLINIC
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3407
Mailing Address - Country:US
Mailing Address - Phone:248-646-6659
Mailing Address - Fax:248-646-6659
Practice Address - Street 1:2075 W BIG BEAVER RD STE 520
Practice Address - Street 2:BIRMINGHAM MAPLE CLINIC
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3407
Practice Address - Country:US
Practice Address - Phone:248-646-6659
Practice Address - Fax:248-646-6659
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401002802101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1922012400OtherGROUP NPI