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General NPI Number Information
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NPI Number | 1134019599
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Entity Type | Individual
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Provider Name | CAROLINE BOOTH BALZER
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Gender | Female
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 121 CHESTERFIELD TOWNE CTR
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1230
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Country | US
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Telephone | 636-730-1601
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Fax |
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Provider Business Mailing Address
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Address Line | 1164 S ACOMA ST UNIT 582
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City | DENVER
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State | CO
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Zip | 80210-1660
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Country | US
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Telephone | 260-444-6888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2025020883
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License Number State | MO
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