Provider Demographics
NPI:1366849044
Name:POLLANDER, BRIANNE ELLEN (BA)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:ELLEN
Last Name:POLLANDER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 GRIMARD ST
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-2217
Mailing Address - Country:US
Mailing Address - Phone:413-262-3360
Mailing Address - Fax:
Practice Address - Street 1:49 GRIMARD ST
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-2217
Practice Address - Country:US
Practice Address - Phone:413-262-3360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health