Healthcare Provider Details

I. General information

NPI: 1902576192
Provider Name (Legal Business Name): STEPHANIE POLIARD HHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE POLIARD HHP

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4716 CASHEL CIR
HOUSTON TX
77069-3504
US

IV. Provider business mailing address

4716 CASHEL CIR
HOUSTON TX
77069-3504
US

V. Phone/Fax

Practice location:
  • Phone: 832-929-7965
  • Fax:
Mailing address:
  • Phone: 832-929-7965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: