Healthcare Provider Details

I. General information

NPI: 1669342283
Provider Name (Legal Business Name): ARLENE POLLOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 BULL ST
COLUMBIA SC
29201-2506
US

IV. Provider business mailing address

9102 WALDEN RD
SILVER SPRING MD
20901-3528
US

V. Phone/Fax

Practice location:
  • Phone: 803-400-6860
  • Fax:
Mailing address:
  • Phone: 803-834-1676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number13863
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: