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General NPI Number Information
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NPI Number | 1083687412
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Entity Type | Individual
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Provider Name | PAULA JOAN JEAN PHD
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1441 VILLAGE POND LN APT 1406
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City | RICHMOND
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State | VA
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Zip | 23227-3496
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Country | US
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Telephone | 804-318-5211
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Fax | 804-369-9709
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Provider Business Mailing Address
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Address Line | 1441 VILLAGE POND LN APT 1406
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City | RICHMOND
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State | VA
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Zip | 23227-3496
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Country | US
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Telephone | 804-318-5211
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Fax | 804-369-9709
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 08100001202
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License Number State | VA
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