Provider Demographics
NPI:1760027023
Name:NEWTON, PAULA ELLEN
Entity Type:Individual
Prefix:MISS
First Name:PAULA
Middle Name:ELLEN
Last Name:NEWTON
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 1:21539 S SORYL AVE
Mailing Address - Street 2:
Mailing Address - City:PECULIAR
Mailing Address - State:MO
Mailing Address - Zip Code:64078-9253
Mailing Address - Country:US
Mailing Address - Phone:417-955-2632
Mailing Address - Fax:
Practice Address - Street 1:21539 S SORYL AVE
Practice Address - Street 2:
Practice Address - City:PECULIAR
Practice Address - State:MO
Practice Address - Zip Code:64078-9253
Practice Address - Country:US
Practice Address - Phone:417-955-2632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO69507225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist