MEDICARE: DR. PAULETTE G. MUNI PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	009578-1	NY
2	103TC0700X	Clinical Psychologist	1007	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346274032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULETTE G. MUNI PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 23794
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29224-3794
Country	:	US
Telephone Number	:	803-462-1313
Fax Number	:	803-462-1390

Provider Business Practice Location Address
First Line	:	9711 GARNERS FERRY RD
Second Line	:
City	:	HOPKINS
State	:	SC
Zip	:	29061-9148
Country	:	US
Telephone Number	:	803-462-1313
Fax Number	:	803-462-1390

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	09/27/2013

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