Polen, Nancy B.

Polen, Nancy B. is an sole proprietor health care provider with primary practice located at 11239 Villa Trace Pl , Charlotte NC 28277-1711. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Polen, Nancy B. can be contacted via phone (704) 540-6317.

Contact Information

Primary practice address
11239 Villa Trace Pl Charlotte NC 28277-1711
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X NC857 North Carolina

Profile Details

NPI number 1619020344
LBN Legal business name Polen, Nancy B.
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 18th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619020344 NPPES
North Carolina MEDICAID 6105071

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