NPI 1376184820

Kevin Polk

Practitioner Marriage & Family Therapist Springfield, IL

Practice location

Address: 350 Bourbon St, Springfield, IL 62707-2702
Phone: (209) 627-7677

Registered specialties

Marriage & Family Therapist Primary

Behavioral Health & Social Service Providers Taxonomy 106H00000X

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Registry record

NPI: 1376184820
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Oct 2019
Record last updated: 7 Oct 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.