Individual
ELLEN BALKOVEC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1803 S BANCROFT ST, PHILADELPHIA, PA 19145-2206
(215) 896-9650
Mailing address
1803 S BANCROFT ST, PHILADELPHIA, PA 19145-2206
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11519937
PA
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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