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Individual

AMY AILEEN BALCAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., ED.S. L.M.H.C.

Contact information

Practice address
1000 COUNTY ROAD WEST LONETREE, LINTON, IN 47441
(812) 847-4435
Mailing address
620 8TH AVE, TERRE HAUTE, IN 47804-0323
(812) 231-8438
(812) 231-8191

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001360A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
119674444
CAQH
IN
Enumeration date
07/17/2007
Last updated
05/21/2012
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