Individual
MS. POLLY JO CORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW R
Contact information
Practice address
218 BIRCHWOOD AVE, NYACK, NY 10960
(845) 348-0721
(845) 348-0721
Mailing address
218 BIRCHWOOD AVE, NYACK, NY 10960
(845) 348-0721
(845) 348-0721
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
051386
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01717133
—
NY
Enumeration date
07/26/2006
Last updated
07/08/2007
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