MEDICARE: MRS. PAULA ANDERSON DEMONET LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	4567	NC

General Provider Information

NPI Number	:	1558566976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULA ANDERSON DEMONET LPC

Provider Business Mailing Address
First Line	:	234 BRYSON WALK
Second Line	:
City	:	BRYSON CITY
State	:	NC
Zip	:	28713-7737
Country	:	US
Telephone Number	:	828-736-2023
Fax Number	:	828-488-9939

Provider Business Practice Location Address
First Line	:	234 BRYSON WALK
Second Line	:
City	:	BRYSON CITY
State	:	NC
Zip	:	28713-7737
Country	:	US
Telephone Number	:	828-736-2023
Fax Number	:	828-488-9939

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2007
Last Update Date	:	11/10/2010

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