Provider Demographics
NPI:1871033498
Name:LEE, PAULA
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:LEE
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 1:3233 S SHERWOOD FOREST BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2250
Mailing Address - Country:US
Mailing Address - Phone:225-302-5804
Mailing Address - Fax:225-302-5825
Practice Address - Street 1:3233 S SHERWOOD FOREST BLVD STE 204
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2250
Practice Address - Country:US
Practice Address - Phone:225-302-5804
Practice Address - Fax:225-302-5825
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0080101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral