Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallory Polivka, MA, R-DMT

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1821514563

Mallory Polivka, MA, R-DMT is a Student in an Organized Health Care Education/Training Program in Duluth, Minnesota. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

101 W 2nd St
Duluth, MN 55802
Phone: (218) 724-3122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1821514563
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , R-DMT
Sole proprietorNo
NPI enumeratedAugust 15, 2017
Last updated in NPPESAugust 20, 2018

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