Most Relevant Information
Provider Data
NPI Number: | 1003535832 |
Provider Name: | DENA LOUISE BALO LAC |
Entity Type: | Individual |
Taxonomy Code: | 101YM0800X |
Specialty: | Counselor |
License Number: | 37AC00663100 |
Most Important Dates
Enumeration Date: | 08/24/2022 |
Last Updated: | 08/24/2022 |
Provider Practice Location
801 LACEY RD
FORKED RIVER
NJ
087311301
Practice Location Phone/Fax
Phone: | 6099718989 |
Fax: |
Provider Mailing Location
801 LACEY RD
FORKED RIVER
NJ
087311301
Provider Mailing Phone/Fax
Phone: | 6099718989 |
Fax: |