Individual
DESTINY POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
609 E CHURCH ST, BOONEVILLE, MS 38829-3711
(662) 728-2488
Mailing address
1867 CRANE RIDGE DR STE 150C, JACKSON, MS 39216-4982
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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