Provider Demographics
NPI:1619762986
Name:MCDONALD, POLLY PINGENOT
Entity type:Individual
Prefix:
First Name:POLLY
Middle Name:PINGENOT
Last Name:MCDONALD
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 1:709 SPRING HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-2903
Mailing Address - Country:US
Mailing Address - Phone:512-944-8195
Mailing Address - Fax:
Practice Address - Street 1:709 SPRING HOLLOW DR
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-2903
Practice Address - Country:US
Practice Address - Phone:512-944-8195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18425101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional