MEDICARE: PAULA ANN PEGG M.ED.

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1679753362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA ANN PEGG M.ED.

Provider Business Mailing Address
First Line	:	3 NESTLES LN
Second Line	:
City	:	EAST FREETOWN
State	:	MA
Zip	:	02717-1716
Country	:	US
Telephone Number	:	508-763-5909
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 NESTLES LN
Second Line	:
City	:	EAST FREETOWN
State	:	MA
Zip	:	02717-1716
Country	:	US
Telephone Number	:	508-763-5909
Fax Number	:

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

Provider Enumeration Date	:	11/09/2007
Last Update Date	:	11/09/2007

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