Provider Demographics
NPI:1396834388
Name:LOMBARD, PAULETTE ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PAULETTE
Middle Name:ANN
Last Name:LOMBARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 457 BOX 163
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09033
Mailing Address - Country:DE
Mailing Address - Phone:09721-476-3059
Mailing Address - Fax:
Practice Address - Street 1:HEALTH CLINIC: SCHWIENFURT
Practice Address - Street 2:USAHC LEDWARD, BLDG. 201
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09033
Practice Address - Country:DE
Practice Address - Phone:0972-196-6276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR048312-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical