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Individual

SHAUNA BALCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
37 W 26TH ST, NEW YORK, NY 10010-1006
(917) 673-2749
Mailing address
75 W 238TH ST, APT. 2H, BRONX, NY 10463-4239
(917) 673-2749

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
022653-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
A100136597
NY
Enumeration date
06/20/2013
Last updated
01/02/2019
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