Provider Demographics
NPI:1013291137
Name:MIELE, PAULA JEAN (CERTIFIED MASSAGE TH)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:JEAN
Last Name:MIELE
Suffix:
Gender:F
Credentials:CERTIFIED MASSAGE TH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 HARVARD STREET
Mailing Address - Street 2:# 40 SECOND FL;THE ARCADE BLDG.
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446
Mailing Address - Country:US
Mailing Address - Phone:617-277-8244
Mailing Address - Fax:
Practice Address - Street 1:318 HARVARD STREET
Practice Address - Street 2:# 40 SECOND FL;THE ARCADE BLDG.
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446
Practice Address - Country:US
Practice Address - Phone:617-277-8244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA#205225700000X
MA#6783225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist