Provider Demographics
NPI:1710117486
Name:SLOAN, PAULA E (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:E
Last Name:SLOAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 GREENLAND DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3018
Mailing Address - Country:US
Mailing Address - Phone:864-467-1788
Mailing Address - Fax:864-235-4789
Practice Address - Street 1:45 GREENLAND DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3018
Practice Address - Country:US
Practice Address - Phone:864-467-1788
Practice Address - Fax:864-235-4789
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC510103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC10Other19