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Individual
MS. TERA DEEANN PAULSON
Active
Individual
MS. TERA DEEANN PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1473
ND
225100000X
Physical Therapist
6871
AZ
225100000X
Physical Therapist
7835
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123437000
—
MN
Enumeration date
05/19/2006
Last updated
02/01/2011
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