Provider Demographics
NPI:1508635194
Name:POLITO, CAROL ANN (CRC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:POLITO
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 WESLEYAN DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3700
Mailing Address - Country:US
Mailing Address - Phone:907-244-2632
Mailing Address - Fax:
Practice Address - Street 1:2633 WESLEYAN DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3700
Practice Address - Country:US
Practice Address - Phone:907-244-2632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor