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Provider Information for 1376905166


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ERICA ALAYNE BALCH LMSW


Sex: Female

NPI: 1376905166
Last Updated: 2016-03-22
Certification Date:

Details

NameValue
NPI1376905166
Enumeration Date2016-03-22
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 2195 IRONWOOD CT
COEUR D ALENE, ID 83814-2628
United States

Phone: 208-769-1406 | Fax:208-769-1430
 
Primary Practice Address 2195 IRONWOOD CT
COEUR D ALENE, ID 83814-2628
United States

Phone: 208-769-1406 | Fax:208-769-1430
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 104100000X - Social Worker IDLMSW-31495