Individual
TARA MICHELLE POLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CC
Contact information
Practice address
207 COMMERCE DR, CHESTERFIELD, SC 29709
(843) 623-2229
Mailing address
PO BOX 918, BENNETTSVILLE, SC 29512
(843) 454-0841
(843) 454-0635
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405127
—
SC
Enumeration date
11/30/2006
Last updated
07/08/2007
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