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General NPI Number Information
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NPI Number | 1629936190
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Entity Type | Individual
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Provider Name | KAELEY EDDISON POLLOCK
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Gender | Female
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 2460 DELANEY AVE
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City | WILMINGTON
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State | NC
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Zip | 28403-6062
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Country | US
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Telephone | 910-338-9093
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Fax |
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Provider Business Mailing Address
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Address Line | 632 CONDO CLUB DR UNIT 107
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City | WILMINGTON
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State | NC
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Zip | 28412-1881
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Country | US
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Telephone |
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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 | A22442
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License Number State | NC
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