| NPI | 1073079208 |
|---|---|
| Former Name | MERCEDES LYNN POLK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2019-02-12 |