Provider Demographics
NPI:1588068167
Name:POLIN, S. VICTORIA (MA)
Entity type:Individual
Prefix:
First Name:S.
Middle Name:VICTORIA
Last Name:POLIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5901 WYOMING BLVD NE STE J
Mailing Address - Street 2:STE. 295
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3873
Mailing Address - Country:US
Mailing Address - Phone:224-534-9155
Mailing Address - Fax:505-214-5724
Practice Address - Street 1:231 SIERRA DR SE
Practice Address - Street 2:STE. 4
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-2714
Practice Address - Country:US
Practice Address - Phone:224-534-9155
Practice Address - Fax:505-214-5724
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2015-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM0167371103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst