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Individual

KASEY BALOG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD, OTR/L

Contact information

Practice address
3420 WEST RD, TRENTON, MI 48183-2323
(734) 215-9569
Mailing address
860 W LABO RD, CARLETON, MI 48117-9330
(734) 752-8823

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201013025
MI

Other

Enumeration date
08/18/2022
Last updated
08/18/2022
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