Provider Demographics
NPI:1861100067
Name:BULLA, PAULA
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:BULLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 EXECUTIVE DR STE F
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-4880
Mailing Address - Country:US
Mailing Address - Phone:217-504-0131
Mailing Address - Fax:
Practice Address - Street 1:25 EXECUTIVE DR STE F
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4880
Practice Address - Country:US
Practice Address - Phone:217-504-0131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor