Individual
MRS. ELISABETH ANNE BALCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,CCC/SLP
Contact information
Practice address
12778 ROAD 37 1/2, MADERA, CA 93636-8757
(559) 430-8239
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP16633
CA
Other
Enumeration date
01/18/2016
Last updated
12/13/2019
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