Individual
BENJAMIN E POLONOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
10 FORREST DR, GRANBY, CO 80446
(303) 828-6756
Mailing address
PO BOX 4251, GRANBY, CO 80446-4251
(303) 828-6756
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.0016481
CO
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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