Provider Demographics
NPI:1699006775
Name:TATE, PAULA (LMT, CNC,CPT)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:TATE
Suffix:
Gender:F
Credentials:LMT, CNC,CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 WASON RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-5123
Mailing Address - Country:US
Mailing Address - Phone:603-886-7232
Mailing Address - Fax:603-886-7232
Practice Address - Street 1:87 WASON RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-5123
Practice Address - Country:US
Practice Address - Phone:603-886-7232
Practice Address - Fax:603-886-7232
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH#228M173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist