| NPI | 1134350366 |
|---|---|
| Former Name | NICOLETTE MARIE BALKIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.008846) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.003966) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2021-02-16 |