Shattuck, Polly A

Shattuck, Polly A is an individual health care provider with primary practice located at 610 Alta Vista St , Santa Fe NM 87505-4149. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / School is her primary health care specialty. Shattuck, Polly A can be contacted via phone (970) 336-4912.

Contact Information

Primary practice address
610 Alta Vista St Santa Fe NM 87505-4149
Phone: (970) 336-4912
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X CSW-1232 Colorado
Behavioral Health & Social Service Providers / School 1041S0200X M-07766 New Mexico

Profile Details

NPI number 1255572160
LBN Legal business name Shattuck, Polly A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2009
Last updated Apr 26th, 2024 - about last year

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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