Provider Demographics
NPI:1851574420
Name:SKIPPER, PAULA MARIE
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:MARIE
Last Name:SKIPPER
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 1:1256 HIGHWAY 138 SW
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-1402
Mailing Address - Country:US
Mailing Address - Phone:770-994-2223
Mailing Address - Fax:770-994-2224
Practice Address - Street 1:1256 HIGHWAY 138 SW
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30296-1402
Practice Address - Country:US
Practice Address - Phone:770-994-2223
Practice Address - Fax:770-994-2224
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health