NPI 1295418713 · live from the CMS NPI Registry
Nicole Rae Balsom
Behavior Analyst in Chagrin Falls, OH. National Provider Identifier 1295418713, active.
NPI record
| NPI | 1295418713 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 150 Holly Ln, Chagrin Falls, OH 44022 |
| Practice phone | 609-558-4007 |
| Mailing address | 37406 Park Ave, Willoughby, OH 44094 |
| Enumerated | August 10, 2023 |
| Last updated | August 10, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.