Individual
VANESSA LARA POLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 E 7TH ST, CHARLOTTE, NC 28204-6300
(704) 780-4271
(704) 788-2016
Mailing address
650 SPRING HAVEN DR, RANDLEMAN, NC 27317-8300
(336) 964-5912
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-60151
NC
Other
Enumeration date
04/14/2020
Last updated
09/01/2023
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