Provider Demographics
NPI:1457745465
Name:PAUL, ALLEN DAVID (MS, MDIV)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:DAVID
Last Name:PAUL
Suffix:
Gender:M
Credentials:MS, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11713 M CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2218
Mailing Address - Country:US
Mailing Address - Phone:402-933-4411
Mailing Address - Fax:
Practice Address - Street 1:11713 M CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2218
Practice Address - Country:US
Practice Address - Phone:402-933-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral