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General NPI Number Information
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NPI Number | 1487455606
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Entity Type | Organization
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Legal Business Name | PAULSEN CHANGE AGENT- THERAPY & COACHING LLC
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 7401 W CHARLESTON BLVD STE 1-124
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City | LAS VEGAS
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State | NV
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Zip | 89117-1401
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Country | US
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Telephone | 213-215-7670
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Fax |
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Provider Business Mailing Address
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Address Line | 848 N RAINBOW BLVD STE 312
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City | LAS VEGAS
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State | NV
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Zip | 89107-1103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANYEL PAULSEN
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Credential |
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Telephone | 213-215-7670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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