Organization
SHEILA A. BALOG, PH.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHEILA A BALOG PHD (PRESIDENT)
(678) 583-4975
Entity
Organization
Contact information
Practice address
55 JONESBORO ST, MCDONOUGH, GA 30253-3164
(678) 583-4975
Mailing address
55 JONESBORO ST, MCDONOUGH, GA 30253-3164
(678) 583-4975
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PSY2369
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00857073C
—
GA
Enumeration date
02/12/2007
Last updated
08/22/2020
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