Provider Demographics
NPI:1932162807
Name:DAY, PAULETTE D (MA)
Entity type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:D
Last Name:DAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 E NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18701-2406
Mailing Address - Country:US
Mailing Address - Phone:570-829-3489
Mailing Address - Fax:570-829-7781
Practice Address - Street 1:33 E NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-2406
Practice Address - Country:US
Practice Address - Phone:570-829-3489
Practice Address - Fax:570-829-7781
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-005483-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA073604OtherFIRST PRIORITY HEALTH
PA2102786OtherCIGNA
PA80355340OtherUNITED BEHAVIORAL HEALTH
PA192560OtherBLUE SHIELD
PA457754000OtherMAGELLAN