Provider Demographics
NPI:1992430490
Name:ACKER, PAULA (MA)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:
Last Name:ACKER
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 1:9143 W PHILLIPS DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-8120
Mailing Address - Country:US
Mailing Address - Phone:720-810-1478
Mailing Address - Fax:
Practice Address - Street 1:9143 W PHILLIPS DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-8120
Practice Address - Country:US
Practice Address - Phone:720-810-1478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty