Individual
MRS. ELIZABETH ANN POLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, CSAC, CSIT
Contact information
Practice address
1654 WASHINGTON AVE, RACINE, WI 53403-2047
(262) 633-5001
(262) 633-2928
Mailing address
1654 WASHINGTON AVE, RACINE, WI 53403-2047
(262) 633-5001
(262) 633-2928
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15374-132
WI
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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