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Individual

LAILA MACKENZIE POLK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
306 CAMBRIDGE ST, FREDERICKSBURG, VA 22405-1400
(843) 592-8582
Mailing address
115 OAKRIDGE DR, ELLENWOOD, GA 30294-2558
(706) 961-0493

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-506294
VA

Other

Enumeration date
02/16/2026
Last updated
02/16/2026
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