Provider Demographics
NPI:1497893481
Name:GRAYSON, PAULA CORREIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:CORREIA
Last Name:GRAYSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-1968
Mailing Address - Country:US
Mailing Address - Phone:203-267-6933
Mailing Address - Fax:
Practice Address - Street 1:7 GARAGE RD
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-3884
Practice Address - Country:US
Practice Address - Phone:203-262-4482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002447103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical