Provider Demographics
NPI:1356042212
Name:DADURA, PAULINA
Entity type:Individual
Prefix:
First Name:PAULINA
Middle Name:
Last Name:DADURA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3956 CHERRY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1036
Mailing Address - Country:US
Mailing Address - Phone:586-265-4973
Mailing Address - Fax:
Practice Address - Street 1:11111 HALL RD STE 201
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5799
Practice Address - Country:US
Practice Address - Phone:586-649-7589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511197341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical