Healthcare Provider Details
I. General information
NPI: 1770214314
Provider Name (Legal Business Name): KARA PAULSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/23/2022
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1272 LONG HILL RD
STIRLING NJ
07980-1010
US
IV. Provider business mailing address
1272 LONG HILL RD
STIRLING NJ
07980-1010
US
V. Phone/Fax
- Phone: 908-504-2700
- Fax:
- Phone: 908-504-2700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: