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General NPI Number Information
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NPI Number | 1104000652
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Entity Type | Individual
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Provider Name | ALLISON POLOMSKY MA, LCMFT, LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 22776 THREE NOTCH RD STE 211
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-3368
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Country | US
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Telephone | 301-304-8995
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Fax |
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Provider Business Mailing Address
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Address Line | 18747 VERNON COURT
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City | DRAYDEN
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State | MD
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Zip | 20630
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Country | US
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Telephone | 402-682-2299
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LCM630
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 157
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License Number State | NE
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