Individual
POLLY A SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
610 ALTA VISTA ST, SANTA FE, NM 87505-4149
(970) 336-4912
Mailing address
928 12TH ST, GREELEY, CO 80631-4024
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CSW-1232
CO
1041S0200X
School Social Worker
Primary
M-07766
NM
Other
Enumeration date
03/23/2009
Last updated
04/26/2024
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