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NPI Code Detail

MEDICARE: JOSH PATRICK TEODORO BALISI

MEDICARE: JOSH PATRICK TEODORO BALISI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianMI

General Provider Information

NPI Number : 1457285355
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSH PATRICK TEODORO BALISI
Provider Business Mailing Address
First Line : 33464 SCHOENHERR RD STE 180
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48312-6392
Country : US
Telephone Number : 586-999-5971
Fax Number :
Provider Business Practice Location Address
First Line : 33464 SCHOENHERR RD STE 180
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48312-6392
Country : US
Telephone Number : 586-999-5971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2026
Last Update Date : 06/09/2026

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Directions to “ JOSH PATRICK TEODORO BALISI ” Practice Location

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