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General NPI Number Information
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NPI Number | 1174138143
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Entity Type | Organization
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Legal Business Name | BALANCE COUNSELING, PLLC
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 802 E BAMBERGER DR
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2184
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Country | US
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Telephone | 801-871-9391
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Fax |
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Provider Business Mailing Address
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Address Line | 1626 N 2640 W
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City | LEHI
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State | UT
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Zip | 84043-3708
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Country | US
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Telephone | 801-871-9391
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. AMANDA GRAY
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Credential | LCSW
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Telephone | 801-871-9391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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