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NPI Code Detail

MEDICARE: SUZANNE LYNN BALKA LPC

MEDICARE:   SUZANNE LYNN BALKA  LPC
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
1101YP2500XProfessional Counselor68504TX

General Provider Information

NPI Number : 1538508528
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE LYNN BALKA LPC
Provider Business Mailing Address
First Line : 1400 BROADFIELD BLVD
Second Line : SUITE 200
City : HOUSTON
State : TX
Zip : 77084-5163
Country : US
Telephone Number : 281-994-7861
Fax Number : 281-994-7801
Provider Business Practice Location Address
First Line : 1400 BROADFIELD BLVD
Second Line : SUITE 200
City : HOUSTON
State : TX
Zip : 77084-5163
Country : US
Telephone Number : 281-994-7861
Fax Number : 281-994-7801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2013
Last Update Date : 08/14/2015

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Directions to “ SUZANNE LYNN BALKA LPC” Practice Location

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