Paula Renee Jackson
Individual provider Active NPI Behavior Analyst · Bloomfield, NM
NPI 1578874574 · NPPES record last updated Jul 8, 2020
Key facts
- NPI
- 1578874574
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 101 E Broadway Ave
Bloomfield, NM 87413-6235 - Phone
- (505) 330-8220
- NPI assigned
- Jun 24, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sadie L Smith-McDaniel | Current |
Accepting new patients | |
| Angel Peak Counseling, LLC | Current |
Accepting new patients |
Locations
101 E Broadway Ave
Bloomfield, NM 87413
Phone (505) 330-8220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
101 E Broadway Ave
Bloomfield, NM 87413-6235
Mailing address
101 E Broadway Ave
Bloomfield, NM 87413-6235
Phone (053) 308-2205
Other practice location 1
1001W broadway
Farmington, NM 87401
Phone (505) 326-2695
Other providers in Bloomfield, NM
- Roy Hernandez
- Ariel Rose Howard
- Colleen Hudson
- Thomas William Hurst
- Jessica Iudiciani
- Julie Rose Jaramillo
- Cierra Johnson
- Tonya Kaye Jordan
- Kare Inc
- Kare Inc.
All providers in Bloomfield, NM · Behavior Analyst in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.