Individual
MR. WILLIE ANDREW POLE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1502 S COLORADO ST, GREENVILLE, MS 38703-7219
(662) 332-9872
Mailing address
1717 FAIRGROUNDS RD APT I2, GREENVILLE, MS 38703-7839
(662) 592-2451
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C7780
MS
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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