Individual
DIANA C BAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHSOT
Contact information
Practice address
109 CHURCHILL CT, SUMMERVILLE, SC 29485-3454
(843) 821-9175
(843) 821-9170
Mailing address
109 CHURCHILL CT, SUMMERVILLE, SC 29485-3454
(843) 821-9175
(843) 821-9170
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
704
SC
225XP0200X
Pediatric Occupational Therapist
Primary
704
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH0663
—
SC
Enumeration date
01/08/2007
Last updated
09/11/2025
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