Individual
SHEILA L BALISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
820 ELM DR, ST MARIES, ID 83861-2119
(208) 245-4576
(208) 245-2138
Mailing address
3708 GRANDVIEW DR, SANDPOINT, ID 83864-7425
(208) 610-6155
(208) 245-2138
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT468
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805673300
—
ID
Enumeration date
07/27/2010
Last updated
07/27/2010
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