Doctor Name: | RALPH SALVATORE POLLARO |
NPI Number: | 1265667679 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 178.006071 |
Business Practice Address: | 2110 York St Blue Island, IL - 604062520 |
Business Phone Number: | 7085977673 |
Business Fax Number: | 7085977673 |
Mailing Address: | 2110 York St, BLUE ISLAND |
State: | IL |
Postal Code: | 604062520 |
Phone Number: | 7085977673 |
Fax Number: | 7085977673 |
NPI Enumeration Date: | 05/29/2009 |
NPI Last Update Date: | 05/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 178.006071 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |