Deborah Lyn Polzin, LLP

Individual provider Active NPI Clinical Psychologist · Iron River, MI

NPI 1295750461 · NPPES record last updated Aug 14, 2008

Key facts

NPI
1295750461
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
6301012659 (MI)
Practice address
703 N 2ND Ave
Iron River, MI 49935-1451
Phone
(906) 265-5126
Fax
(906) 265-5878
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6301012659MIMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301012659 MI Yes

Addresses

Primary practice location

703 N 2ND Ave
Iron River, MI 49935-1451

Mailing address

715 Pyle Dr
Kingsford, MI 49802-4456
Phone (906) 774-0522

Other identifiers

IdentifierTypeStateIssuer
DP012659OtherMIBCBS OF MI

Other providers in Iron River, MI

All providers in Iron River, MI · Clinical Psychologist in Michigan

Sources for this page

Verify at the official NPI Registry.