Individual
MS. RHONDA JOY POLAKOFF
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
26231 E US HIGHWAY 64, TAOS, NM 87571-7101
(214) 876-5778
Mailing address
26231 E US HIGHWAY 64, TAOS, NM 87571-7101
(214) 876-5778
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2-5796
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113365402
—
TX
01
—
86669A
BCBS
TX
Enumeration date
08/03/2005
Last updated
07/06/2021
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