Provider Demographics
NPI:1790167005
Name:MCDONOUGH, PAULA A (SPEECH BS/ME)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:A
Last Name:MCDONOUGH
Suffix:
Gender:F
Credentials:SPEECH BS/ME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BERKELEY ST
Mailing Address - Street 2:
Mailing Address - City:JENKINS TWP
Mailing Address - State:PA
Mailing Address - Zip Code:18640-2961
Mailing Address - Country:US
Mailing Address - Phone:570-472-1099
Mailing Address - Fax:
Practice Address - Street 1:2209 SCHOOLEY RD
Practice Address - Street 2:
Practice Address - City:HARDING
Practice Address - State:PA
Practice Address - Zip Code:18643-2913
Practice Address - Country:US
Practice Address - Phone:570-262-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist