Healthcare Provider Details

I. General information

NPI: 1790712321
Provider Name (Legal Business Name): VICKI COHN POLLARD L.AC., M.AC., LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SPRUCE NEEDLE LANE
BLUE HILL ME
04614
US

IV. Provider business mailing address

PO BOX 838
BLUE HILL ME
04614-0838
US

V. Phone/Fax

Practice location:
  • Phone: 207-374-9963
  • Fax: 207-374-2946
Mailing address:
  • Phone: 207-374-9963
  • Fax: 207-374-2946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC5
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: