Individual
MS. TARA A BALUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., T.L.L.P
Contact information
Practice address
650 GRISWOLD ST, NORTHVILLE, MI 48167-1666
(248) 912-0080
Mailing address
650 GRISWOLD ST, NORTHVILLE, MI 48167-1666
(248) 912-0080
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015054
MI
Other
Enumeration date
03/19/2016
Last updated
03/19/2016
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