Provider Demographics
NPI:1336991728
Name:SAMMONS, PAULA CHRISTINE (MA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:CHRISTINE
Last Name:SAMMONS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:CHRISTINE
Other - Last Name:DENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:121 TYLER DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-6313
Mailing Address - Country:US
Mailing Address - Phone:865-603-5383
Mailing Address - Fax:
Practice Address - Street 1:121 TYLER DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-6313
Practice Address - Country:US
Practice Address - Phone:865-603-5383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2285101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health