Provider Demographics
NPI:1174397046
Name:POLLIO, SHIRA PREISER
Entity type:Individual
Prefix:
First Name:SHIRA
Middle Name:PREISER
Last Name:POLLIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHIRA
Other - Middle Name:
Other - Last Name:PREISER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1905 WOODSTOCK RD STE 3250
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-5622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1905 WOODSTOCK RD STE 3100
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-5618
Practice Address - Country:US
Practice Address - Phone:470-607-5787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker