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NPI Code Detail

MEDICARE: MRS. DAWN M. POLCYN EDS

MEDICARE: MRS. DAWN M. POLCYN EDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool Psychologist
2103TS0200XSchool Psychologist3772694AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194880260
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DAWN M. POLCYN EDS
Provider Business Mailing Address
First Line : 701 WEST WETMORE RD. RM. 168
Second Line : PIMA COUNTY AMPHITHEATER SCHOOS DBA AMPHITHEATER PUBLIC
City : TUCSON
State : AZ
Zip : 85705-1547
Country : US
Telephone Number : 520-696-5237
Fax Number : 520-696-5067
Provider Business Practice Location Address
First Line : 701 WEST WETMORE RD. RM. 168
Second Line : AMPHITHEATER PUBLIC SCHOOLS
City : TUCSON
State : AZ
Zip : 85705-1547
Country : US
Telephone Number : 520-696-5237
Fax Number : 520-696-5067
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2006
Last Update Date : 03/29/2011

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