Provider Demographics
NPI:1770852956
Name:MOONEY, PAULA F (MSPT)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:F
Last Name:MOONEY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 WILMER DR
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122-9749
Mailing Address - Country:US
Mailing Address - Phone:970-317-0462
Mailing Address - Fax:970-884-6017
Practice Address - Street 1:795 WILMER DR
Practice Address - Street 2:
Practice Address - City:BAYFIELD
Practice Address - State:CO
Practice Address - Zip Code:81122-9749
Practice Address - Country:US
Practice Address - Phone:970-317-0462
Practice Address - Fax:970-884-6017
Is Sole Proprietor?:No
Enumeration Date:2011-12-18
Last Update Date:2011-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist