Provider Demographics
NPI:1356572788
Name:SQUITIERI, PAULA (PHD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:SQUITIERI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:SQUITIERI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:8440 W LAKE MEAD BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7648
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8440 W LAKE MEAD BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7648
Practice Address - Country:US
Practice Address - Phone:702-486-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPYO316101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional