Doctor Name: | CAROLINE POLAND |
NPI Number: | 1710397161 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 2101 N Walnut St Hartford City, IN - 473481367 |
Business Phone Number: | 2605638453 |
Business Fax Number: | 2605690335 |
Mailing Address: | 3563 S State Road 13, WABASH |
State: | IN |
Postal Code: | 469929162 |
Phone Number: | 2605638453 |
Fax Number: | 2605690335 |
NPI Enumeration Date: | 05/06/2014 |
NPI Last Update Date: | 05/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |