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NPI Code Detail

MEDICARE: LISA MARIE POLL

MEDICARE: LISA MARIE POLL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1689517526
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE POLL
Provider Business Mailing Address
First Line : 2485 W 2775 N
Second Line :
City : FARR WEST
State : UT
Zip : 84404-8716
Country : US
Telephone Number : 801-556-1544
Fax Number :
Provider Business Practice Location Address
First Line : 930 W HILL FIELD RD STE A
Second Line :
City : LAYTON
State : UT
Zip : 84041-4687
Country : US
Telephone Number : 801-336-3040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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Directions to “ LISA MARIE POLL ” Practice Location

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