Provider Demographics
NPI:1346233095
Name:POLLARD, STEVEN R (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:POLLARD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:425 CROSS ST
Mailing Address - Street 2:111
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-4877
Mailing Address - Country:US
Mailing Address - Phone:941-505-6162
Mailing Address - Fax:941-505-8604
Practice Address - Street 1:425 CROSS ST
Practice Address - Street 2:111
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-4877
Practice Address - Country:US
Practice Address - Phone:941-505-6162
Practice Address - Fax:941-505-8604
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-29
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5711103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54207OtherBCBS
FL54207Medicare ID - Type Unspecified