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General NPI Number Information
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NPI Number | 1225325053
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Entity Type | Individual
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Provider Name | PAULINA MARIE CONNELLY
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Gender | Female
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 1344 DISC DR # 3090
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City | SPARKS
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State | NV
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Zip | 89436-0684
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Country | US
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Telephone | 775-502-8592
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Fax |
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Provider Business Mailing Address
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Address Line | 1344 DISC DR # 3090
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City | SPARKS
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State | NV
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Zip | 89436-0684
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Country | US
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Telephone | 775-502-8592
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 171W00000X - CONTRAC
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License Number State | NV
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