Individual
REBECCA BALOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1919 REDROSE DR, MAIDENS, VA 23102-2127
(804) 476-4380
Mailing address
1919 REDROSE DR, MAIDENS, VA 23102-2127
(804) 476-4380
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119006829
VA
Other
Enumeration date
12/01/2016
Last updated
11/11/2025
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