Provider Demographics
NPI:1093407728
Name:BALAGUER, CARLOTA (BS)
Entity Type:Individual
Prefix:
First Name:CARLOTA
Middle Name:
Last Name:BALAGUER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 BROADWAY ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-2488
Mailing Address - Country:US
Mailing Address - Phone:715-577-6235
Mailing Address - Fax:
Practice Address - Street 1:414 BROADWAY ST STE 101
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-2488
Practice Address - Country:US
Practice Address - Phone:715-577-6235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator