Individual provider · Type 1 NPI

Mallory Polivka, M.A., R-DMT

Student in an Organized Health Care Education/Training Program · Duluth, MN

NPI number 1821514563 Active

Practice location

101 W 2nd St
Duluth, MN 55802

Call (218) 724-3122 Map

Mailing address

211 Morley Pkwy
Duluth, MN 55803-2127

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1821514563

Mallory Polivka, M.A., R-DMT's National Provider Identifier is 1821514563, issued on Aug 15, 2017. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Duluth, MN. The record was last updated on Aug 20, 2018.