Provider Demographics
NPI:1538480488
Name:POLLNER, JACQUELINE MARY (LCMHC)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MARY
Last Name:POLLNER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2950
Mailing Address - Country:US
Mailing Address - Phone:978-254-1135
Mailing Address - Fax:833-303-0463
Practice Address - Street 1:12 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2950
Practice Address - Country:US
Practice Address - Phone:978-254-1135
Practice Address - Fax:833-303-0463
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health