Healthcare Provider Details

I. General information

NPI: 1841494697
Provider Name (Legal Business Name): PAULA WHITING CREIGHTON MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 NORTH ST
NEW BEDFORD MA
02740-2766
US

IV. Provider business mailing address

14 LITTLE RIVER RD
DARTMOUTH MA
02748-1306
US

V. Phone/Fax

Practice location:
  • Phone: 508-984-5566
  • Fax: 508-994-5527
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: