Individual
MARCIA LYNISE BALOGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1200 N TELEGRAPH RD DEPT 32, PONTIAC, MI 48341-1032
(800) 395-3223
Mailing address
6549 TOWN CENTER DR STE A, CLARKSTON, MI 48346-4824
(800) 395-3223
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4703081421
MI
164W00000X
Licensed Practical Nurse
Primary
4703081421
MI
Other
Enumeration date
03/28/2026
Last updated
03/30/2026
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