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Individual

CARLY POLLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3251 W 9TH ST, WATERLOO, IA 50702-5310
(319) 234-2893
Mailing address
3251 W 9TH ST, WATERLOO, IA 50702-5310
(319) 234-2893

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
093777
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0074435
IA
Enumeration date
09/06/2019
Last updated
09/06/2019
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