Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | C4922 | MS |
NPI | 1003055773 |
---|---|
Provider Name | Paula G Hand |
First Address | Hattiesburg, MS 39402-8455 |
Second Address | Hattiesburg, MS 39402-8455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2009 |
Last Update Date | 06/03/2009 |