Individual
HEATHER DIANE BALZOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
675 N 5TH ST, LEBANON, OR 97355-2875
(541) 451-6282
(541) 812-2038
Mailing address
PO BOX 1193, CORVALLIS, OR 97339-1193
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L7178
OR
Other
Enumeration date
10/26/2016
Last updated
11/10/2020
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