Provider Demographics
NPI:1962866558
Name:POLZIN, KATHERINE LYNN (QMHS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LYNN
Last Name:POLZIN
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FREEDOM DR
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-9029
Mailing Address - Country:US
Mailing Address - Phone:800-468-4357
Mailing Address - Fax:
Practice Address - Street 1:400 FREEDOM DR
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-9029
Practice Address - Country:US
Practice Address - Phone:800-468-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst