Provider Information for 1376151597
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PAUL AFANASI POLANSKI LCSW
Sex: Male
NPI: 1376151597
Last Updated: 2022-11-17
Certification Date: 2022-11-17
Certification Date: 2022-11-17
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1376151597 | ||||||||
| Enumeration Date | 2020-07-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3217 FIECHTNER DR S STE C FARGO, ND 58103-8735 United States Phone: 701-630-8813 | Fax: | ||||||||
| Primary Practice Address | 3217 FIECHTNER DR S STE C FARGO, ND 58103-8735 United States Phone: 701-630-8813 | Fax: | ||||||||
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