| Cheryl A Polly L P C Pc | |
|
909 8th St Ste 300 Wichita Falls TX 76301-6820 | |
| (940) 767-2914 | |
| (866) 838-5630 |
| Full Name | Cheryl A Polly L P C Pc |
|---|---|
| Speciality | Counselor |
| Location | 909 8th St Ste 300, Wichita Falls, Texas |
| Authorized Official Name and Position | Cheryl Polly (PROVIDER) |
| Authorized Official Contact | 9407672914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheryl A Polly L P C Pc 909 8th St Ste 300 Wichita Falls TX 76301-6820 Ph: (940) 767-2914 | Cheryl A Polly L P C Pc 909 8th St Ste 300 Wichita Falls TX 76301-6820 Ph: (940) 767-2914 |
| NPI Number | 1184498669 |
|---|---|
| Provider Enumeration Date | 11/14/2023 |
| Last Update Date | 11/17/2023 |
| Certification Date | 11/17/2023 |
| Medicare PECOS PAC ID | 1658720008 |
|---|---|
| Medicare Enrollment ID | O20231211000694 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184498669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| Provider Name | Cheryl A Polly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194777896 PECOS PAC ID: 2567811912 Enrollment ID: I20231211000808 |
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