Provider Demographics
NPI:1386328565
Name:TACKER, PAULA RENEE (LMSW)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:RENEE
Last Name:TACKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:RENEE
Other - Last Name:SCHNUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:799 COUNTY ROAD 706
Mailing Address - Street 2:
Mailing Address - City:BUNA
Mailing Address - State:TX
Mailing Address - Zip Code:77612-2543
Mailing Address - Country:US
Mailing Address - Phone:409-673-6516
Mailing Address - Fax:
Practice Address - Street 1:799 COUNTY ROAD 706
Practice Address - Street 2:
Practice Address - City:BUNA
Practice Address - State:TX
Practice Address - Zip Code:77612-2543
Practice Address - Country:US
Practice Address - Phone:409-673-6516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker