Individual
MR. JED JEROME BALESTRIERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
1405 WELLINGTON AVE, GRAND JUNCTION, CO 81501-8230
(970) 244-3822
(970) 243-5984
Mailing address
1405 WELLINGTON AVE, GRAND JUNCTION, CO 81501-8230
(970) 244-3822
(970) 243-5984
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
992861
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31900038
THE COLORADO MEDICAL ASSISTANCE PROGRAM - MEDICAID
CO
Enumeration date
03/03/2009
Last updated
03/03/2009
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