Doctor Name: | LAWRENCE JOHN POLLACK |
NPI Number: | 1013988518 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 006156 |
Business Practice Address: | 1273 Hickory Ln Houghton, MI - 499311609 |
Business Phone Number: | 9064828332 |
Business Fax Number: | |
Mailing Address: | 1273 Hickory Ln, HOUGHTON |
State: | MI |
Postal Code: | 499311609 |
Phone Number: | 9064828332 |
Fax Number: | |
NPI Enumeration Date: | 02/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 006156 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |