Individual
ELIZABETH DAKELMAN BALOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
0062
MD
225X00000X
Occupational Therapist
Primary
03037
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03037
MD STATE BOARD OF OCCUPATIONAL THERY PRACTITIONERS
MD
Enumeration date
11/05/2018
Last updated
11/05/2018
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