Individual
MS. NANCY B. POLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
11239 VILLA TRACE PL, CHARLOTTE, NC 28277-1711
(704) 540-6317
Mailing address
11239 VILLA TRACE PL, CHARLOTTE, NC 28277-1711
(704) 540-6317
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
NC857
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6105071
—
NC
Enumeration date
01/18/2007
Last updated
07/08/2007
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