Provider Demographics
NPI:1609274190
Name:LOFTON, PAULA
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:LOFTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 S 68TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-3321
Mailing Address - Country:US
Mailing Address - Phone:215-805-5574
Mailing Address - Fax:856-482-8420
Practice Address - Street 1:3011 S 68TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-3321
Practice Address - Country:US
Practice Address - Phone:215-805-5574
Practice Address - Fax:856-482-8420
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health