Provider Demographics
NPI:1790712321
Name:POLLARD, VICKI COHN (LAC, MAC, LMT)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:COHN
Last Name:POLLARD
Suffix:
Gender:F
Credentials:LAC, MAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 838
Mailing Address - Street 2:
Mailing Address - City:BLUE HILL
Mailing Address - State:ME
Mailing Address - Zip Code:04614-0838
Mailing Address - Country:US
Mailing Address - Phone:207-374-9963
Mailing Address - Fax:207-374-2946
Practice Address - Street 1:9 SPRUCE NEEDLE LANE
Practice Address - Street 2:
Practice Address - City:BLUE HILL
Practice Address - State:ME
Practice Address - Zip Code:04614
Practice Address - Country:US
Practice Address - Phone:207-374-9963
Practice Address - Fax:207-374-2946
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC5171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist