Individual
ROBERT WADE BALENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
19590 CLUB HOUSE RD, MONTGOMERY VILLAGE, MD 20886-3002
(301) 948-5414
Mailing address
17005 TEAL CT, ROCKVILLE, MD 20855-2060
(301) 789-1932
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
00416
MD
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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