Individual
DR. PAMELA VIRGINIA BALENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LPC
Contact information
Practice address
1100 LUDINGTON ST, SUITE 301 A, ESCANABA, MI 49829-3542
(906) 233-1848
Mailing address
PO BOX 554, ESCANABA, MI 49829-0554
(906) 233-1848
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401007925
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11635181
CAQH
—
Enumeration date
10/01/2006
Last updated
07/08/2007
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