Provider Demographics
NPI:1710190020
Name:HAIRSTON, PALEAH L (BS)
Entity Type:Individual
Prefix:MRS
First Name:PALEAH
Middle Name:L
Last Name:HAIRSTON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3814 KINGSLEY DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-1561
Mailing Address - Country:US
Mailing Address - Phone:717-221-9394
Mailing Address - Fax:717-238-7662
Practice Address - Street 1:1100 S CAMERON ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-2547
Practice Address - Country:US
Practice Address - Phone:717-238-7662
Practice Address - Fax:717-238-7894
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health