Provider Demographics
NPI:1952709545
Name:MCCALL, PAUINA (RMFTI)
Entity Type:Individual
Prefix:MRS
First Name:PAUINA
Middle Name:
Last Name:MCCALL
Suffix:
Gender:F
Credentials:RMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10351 LONE STAR PL
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-1345
Mailing Address - Country:US
Mailing Address - Phone:954-812-8750
Mailing Address - Fax:
Practice Address - Street 1:10351 LONE STAR PL
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-1345
Practice Address - Country:US
Practice Address - Phone:954-812-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-12
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT2105106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist