Kevin Polk

NPI #1376184820 in Springfield, Illinois

Provider Information

NPI Number: 1376184820
Entity Type: Individual
Name: Kevin Polk
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Marriage & Family Therapist
Enumeration Date: Oct 7, 2019
Last Updated: Oct 7, 2019

Practice Location

Address: 350 BOURBON ST
City: Springfield
State: Illinois
ZIP Code: 62707-2702
Phone: (209) 627-7677

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Marriage & Family Therapist	106H00000X	Primary

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