Healthcare Provider Details

I. General information

NPI: 1700820511
Provider Name (Legal Business Name): WILLIAM R POLLARD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 FRIES MILL RD
TURNERSVILLE NJ
08012-2055
US

IV. Provider business mailing address

149 PELHAM RD
PHILADELPHIA PA
19119-2661
US

V. Phone/Fax

Practice location:
  • Phone: 856-523-0221
  • Fax:
Mailing address:
  • Phone: 856-589-0221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3111
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3111
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number5551L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: