Individual
SUSAN L. PAULY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D. HSPP
Contact information
Practice address
1132A S ROGERS ST, BLOOMINGTON, IN 47403-4770
(812) 335-0605
(812) 335-0606
Mailing address
1132A S ROGERS ST, BLOOMINGTON, IN 47403-4770
(812) 335-0605
(812) 335-0606
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
20041215A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007851384
AETNA PIN#
IN
01
—
2027007
CIGNA PIN #
IN
01
—
548896P
SIHO PIN #
IN
01
—
NON-PAR
ANTHEM PIN#
IN
Enumeration date
10/23/2006
Last updated
07/08/2007
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