Individual
BREONNA LEE POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 SMART PL STE B, SLIDELL, LA 70458
(504) 241-6006
Mailing address
416 JOSEPH ST APT 5, SLIDELL, LA 70458-8570
(985) 259-9948
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/10/2015
Last updated
10/13/2023
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