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General NPI Number Information
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NPI Number | 1235019803
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Entity Type | Individual
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Provider Name | ABIGAIL STERLING POLLYEA
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Gender | Female
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 3220 E JEFFERSON BLVD
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City | SOUTH BEND
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State | IN
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Zip | 46615-3028
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Country | US
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Telephone | 574-222-2466
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Fax |
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Provider Business Mailing Address
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Address Line | 50962 STURDY OAK LN
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City | GRANGER
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State | IN
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Zip | 46530-9173
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Country | US
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Telephone | 574-315-0254
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 88002961A
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License Number State | IN
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