Individual
MRS. SHIRLEY HENDERSON POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN-MSN-LPC
Contact information
Practice address
6991 E CAMELBACK RD, SUITE #B360, SCOTTSDALE, AZ 85251
(480) 429-9044
(480) 429-9048
Mailing address
5446 E EXETER BLVD, PHOENIX, AZ 85018
(602) 957-1119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AZDBHS #CC0545
AZ
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
RN015602
AZ
Other
Enumeration date
06/05/2009
Last updated
06/05/2009
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