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General NPI Number Information
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NPI Number | 1922297688
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Entity Type | Individual
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Provider Name | ANDREW S. POLLAK L.M.F.T.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 99 WHITFIELD ST
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City | GUILFORD
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State | CT
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Zip | 06437-3429
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Country | US
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Telephone | 203-453-5753
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Fax |
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Provider Business Mailing Address
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Address Line | 3 HOME STAKE LN
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City | KILLINGWORTH
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State | CT
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Zip | 06419-2423
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Country | US
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Telephone | 860-663-3000
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Fax | 860-663-1335
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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 | 000612
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License Number State | CT
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