Individual
MARVIN LOUIS POLSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3505 WASHINGTON BLVD, INDIANAPOLIS, IN 46205-3718
(317) 920-5900
(317) 920-5911
Mailing address
3505 WASHINGTON BLVD, INDIANAPOLIS, IN 46205-3718
(317) 920-5900
(317) 920-5911
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002649A
IN
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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