Provider Demographics
NPI:1306096326
Name:POLCHIES SAULIS, NORMA JEAN (OQMHP-COMMUNITY)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:JEAN
Last Name:POLCHIES SAULIS
Suffix:
Gender:F
Credentials:OQMHP-COMMUNITY
Other - Prefix:
Other - First Name:NORMA
Other - Middle Name:JEAN
Other - Last Name:POLCHIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 EDGEMONT DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-2036
Mailing Address - Country:US
Mailing Address - Phone:207-762-3310
Mailing Address - Fax:207-762-3307
Practice Address - Street 1:1 EDGEMONT DR
Practice Address - Street 2:SUITE 2
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2036
Practice Address - Country:US
Practice Address - Phone:207-762-3310
Practice Address - Fax:207-762-3307
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME103850000OtherMAINECARE