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Individual

DAVID A POLENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW-C

Contact information

Practice address
724 HIGH ROCK RD N, HANOVER, PA 17331-6863
(717) 969-5217
Mailing address
445 HAMILTON AVE # OEC73, WHITE PLAINS, NY 10601-1807

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
03571
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
532201400
MD
05
615501400
MD
Enumeration date
12/28/2006
Last updated
09/23/2020
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