Individual
ELLEN BALZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11 BALA AVE, BALA CYNWYD, PA 19004-3201
(215) 519-4056
Mailing address
11 BALA AVE, BALA CYNWYD, PA 19004-3201
(215) 519-4056
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS009029-L
PA
103TC0700X
Clinical Psychologist
PS009029-L
PA
103TP2701X
Group Psychotherapy Psychologist
PS009029-L
PA
106H00000X
Marriage & Family Therapist
PS009029-L
PA
Other
Enumeration date
07/11/2006
Last updated
07/14/2007
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