Individual
HAGEN LEVENTIS BALOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Mailing address
215 CLEARBROOK CIR, LEXINGTON, SC 29072-4403
(803) 730-5202
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5502
SC
Other
Enumeration date
03/05/2019
Last updated
01/31/2024
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