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General NPI Number Information
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NPI Number | 1730987587
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Entity Type | Individual
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Provider Name | STEPHANIE ANN BALOW PHD, FACMG
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Gender | Female
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 3333 BURNET AVENUE MLC 7016
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City | CINCINNATI
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State | OH
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Zip | 45229
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Country | US
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Telephone | 513-803-4474
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Fax | 513-636-4373
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVENUE MLC 7016
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City | CINCINNATI
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State | OH
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Zip | 45229
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Country | US
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Telephone | 513-803-4474
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Fax | 513-636-4373
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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 | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State |
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