Provider Demographics
NPI:1467957258
Name:POLLARD, DONNA
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:POLLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4528 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3803
Mailing Address - Country:US
Mailing Address - Phone:404-900-8279
Mailing Address - Fax:216-303-9294
Practice Address - Street 1:4145 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3042
Practice Address - Country:US
Practice Address - Phone:404-900-8279
Practice Address - Fax:216-303-9294
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker