Organization
POLARIS MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARRY DALE (OFFICE MANAGER)
(617) 316-6776
Entity
Organization
Contact information
Practice address
10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517
(571) 229-8708
Mailing address
10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/20/2024
Last updated
12/20/2024
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