Provider Demographics
NPI:1730233313
Name:THOMAS, PAULA JEAN (PHD)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:JEAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17515 W 9 MILE RD
Mailing Address - Street 2:SUITE 975
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4403
Mailing Address - Country:US
Mailing Address - Phone:248-557-3030
Mailing Address - Fax:248-557-4214
Practice Address - Street 1:17515 W 9 MILE RD
Practice Address - Street 2:SUITE 975
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4403
Practice Address - Country:US
Practice Address - Phone:248-557-3030
Practice Address - Fax:248-557-4214
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301003342103TB0200X, 103TC0700X, 103TE1100X, 103TH0100X, 103TP2701X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI037366OtherVALUE OPTIONS PROVIDER ID
MIOF32385OtherBCBS PROVIDER ID#
MIOF32385OtherBCBS PROVIDER ID#
MI037366OtherVALUE OPTIONS PROVIDER ID