Individual
MRS. LISA POLK-WOOLFOLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LLPC, CAC-M
Contact information
Practice address
3731 RIVARD ST, DETROIT, MI 48207-4740
(313) 258-9713
Mailing address
3731 RIVARD ST, DETROIT, MI 48207-4740
(313) 258-9713
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
104717
MI
101YP2500X
Professional Counselor
Primary
6401012200
MI
104100000X
Social Worker
6802063821
MI
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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