Individual
MRS. MARIVIC BALASOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,RNC,CNNP
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-0467
Mailing address
1126 BRUNSWICK, ROCHESTER HILLS, MI 48309-3759
(313) 916-0467
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
4704142699
MI
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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