Most Relevant Information
Provider Data
| NPI Number: | 1003513573 |
| Provider Name: | MARY ANN POLISH |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/14/2023 |
| Last Updated: | 02/14/2023 |
Provider Practice Location
NO ADDRESS
DEETH
NV
89823
Practice Location Phone/Fax
| Phone: | 7753408580 |
| Fax: |
Provider Mailing Location
PO BOX 57
DEETH
NV
898230057
Provider Mailing Phone/Fax
| Phone: | 7753408580 |
| Fax: |