Provider Demographics
NPI:1962184580
Name:RICHARDSON, PAULA (MED CCC-SLP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7541 E 600 S
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84317-9772
Mailing Address - Country:US
Mailing Address - Phone:801-645-7386
Mailing Address - Fax:
Practice Address - Street 1:7541 E 600 S
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84317-9772
Practice Address - Country:US
Practice Address - Phone:801-645-7386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist