Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 222851 | MA |
NPI | 1003438011 |
---|---|
Provider Name | Sara Janet Balajthy |
First Address | Dedham, MA 02026-6815 |
Second Address | Dedham, MA 02026-6815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2020 |
Last Update Date | 13/05/2020 |