Provider Demographics
NPI:1467743351
Name:PULLEN, PAQUITA RENEE (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:PAQUITA
Middle Name:RENEE
Last Name:PULLEN
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 GLANCY ST STE 203
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2313
Mailing Address - Country:US
Mailing Address - Phone:615-424-7908
Mailing Address - Fax:
Practice Address - Street 1:110 GLANCY ST STE 203
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2313
Practice Address - Country:US
Practice Address - Phone:615-424-7908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4537101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health