Individual
EDRICE POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2211 COLUMBIA AVE, PRENTISS, MS 39474-0712
(601) 606-5012
(601) 792-4311
Mailing address
PO BOX 712, PRENTISS, MS 39474-0712
(601) 606-5012
(601) 792-4311
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
33
MS
Other
Enumeration date
04/24/2017
Last updated
04/24/2017
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