Tegan Mallary Polhamus, LICSW

NPI #1063709806 in Gloucester, Massachusetts

Provider Information

NPI Number: 1063709806
Entity Type: Individual
Name: Tegan Mallary Polhamus, LICSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LICSW
Enumeration Date: Jun 30, 2011
Last Updated: Jan 30, 2018

Practice Location

Address: 3 BLACKBURN CENTER
City: Gloucester
State: Massachusetts
ZIP Code: 01930
Phone: (978) 283-7793

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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