Provider Demographics
NPI:1407906431
Name:POLATSEK, JUNE (MA)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:
Last Name:POLATSEK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 S FREEMAN RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-7855
Mailing Address - Country:US
Mailing Address - Phone:520-731-0783
Mailing Address - Fax:520-327-7699
Practice Address - Street 1:4400 E BROADWAY BLVD
Practice Address - Street 2:SUITE 704
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3517
Practice Address - Country:US
Practice Address - Phone:520-327-6081
Practice Address - Fax:520-327-7699
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0672101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor