Healthcare Provider Details

I. General information

NPI: 1750943361
Provider Name (Legal Business Name): PAULA JEAN MACDOUGALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 MERRIMACK ST
LAWRENCE MA
01843-1788
US

IV. Provider business mailing address

6 FERNWOOD DR
ATKINSON NH
03811-2228
US

V. Phone/Fax

Practice location:
  • Phone: 978-620-0290
  • Fax:
Mailing address:
  • Phone: 603-489-9613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: