Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | OH |
NPI | 1003312687 |
---|---|
Provider Name | Curt Michael Balas |
First Address | Shelby, OH 44875-9466 |
Second Address | Shelby, OH 44875-9466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2018 |
Last Update Date | 03/04/2018 |