Provider Demographics
NPI:1629388707
Name:SIGNORA, PAULA K (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:K
Last Name:SIGNORA
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OAK TREE LN
Mailing Address - Street 2:
Mailing Address - City:LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06371-3639
Mailing Address - Country:US
Mailing Address - Phone:860-670-6950
Mailing Address - Fax:
Practice Address - Street 1:4 OAK TREE LN
Practice Address - Street 2:
Practice Address - City:LYME
Practice Address - State:CT
Practice Address - Zip Code:06371-3639
Practice Address - Country:US
Practice Address - Phone:860-670-6950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003008235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist