Provider Demographics
NPI:1881842508
Name:HALLETT, PAULA
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:HALLETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:HALLETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT,PC
Mailing Address - Street 1:7103 BRIDGEMONT CT
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7416
Mailing Address - Country:US
Mailing Address - Phone:317-272-1114
Mailing Address - Fax:
Practice Address - Street 1:7103 BRIDGEMONT CT
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7416
Practice Address - Country:US
Practice Address - Phone:317-272-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN68000044A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist