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General NPI Number Information
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NPI Number | 1760162192
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Entity Type | Individual
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Provider Name | GABRIELLE BALMER
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Gender | Female
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 311 4TH ST SW # 227
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City | WILLMAR
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State | MN
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Zip | 56201-3331
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Country | US
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Telephone | 855-454-2463
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Fax |
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Provider Business Mailing Address
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Address Line | 905 AUGUSTA AVE
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City | WILLMAR
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State | MN
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Zip | 56201-4663
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Country | US
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Telephone | 828-395-0813
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | MN
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