Healthcare Provider Details

I. General information

NPI: 1578234274
Provider Name (Legal Business Name): ANNA MARIE POLLARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 BANTING DR
GEORGETOWN OH
45121-1460
US

IV. Provider business mailing address

2600 VICTORY PKWY
CINCINNATI OH
45206-1711
US

V. Phone/Fax

Practice location:
  • Phone: 937-378-4811
  • Fax:
Mailing address:
  • Phone: 513-751-7747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number163014
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: