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Individual
GEORGE POLISZUK
Active
Individual
GEORGE POLISZUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T1313
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043509821
—
OR
01
—
T1313
OREGON BOARD OF LICENSED PROFESSIONAL COUNSELORS
OR
Enumeration date
04/01/2011
Last updated
02/13/2023
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