Provider Demographics
NPI:1902904733
Name:POLLAK, R TIMOTHY (PHD)
Entity Type:Individual
Prefix:
First Name:R
Middle Name:TIMOTHY
Last Name:POLLAK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8326 S CARR ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-6128
Mailing Address - Country:US
Mailing Address - Phone:303-978-1700
Mailing Address - Fax:303-972-0757
Practice Address - Street 1:8326 S CARR ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-6128
Practice Address - Country:US
Practice Address - Phone:303-972-0714
Practice Address - Fax:303-972-0757
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO768103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist