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Individual

MS. MARY DENNISE POLLYEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
105 RED OAK LANE, JASPER, AR 72641
(870) 446-6449
Mailing address
105 RED OAK LANE, JASPER, AR 72641
(870) 446-6449

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2220C
AR
1041C0700X
Clinical Social Worker
3779
LA

Other

Enumeration date
06/16/2008
Last updated
06/16/2008
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