NPI | 1063976462 |
---|---|
Other Name | SHAKENDRA POLK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 167G00000X Licensed Psychiatric Technician |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV 846512) |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: NV 846512) | |
Enumeration Date | 2019-01-30 |
Last Update Date | 2025-08-20 |