Provider Demographics
NPI:1558142125
Name:BALOY, CLEDELENE JOY (MA)
Entity Type:Individual
Prefix:
First Name:CLEDELENE
Middle Name:JOY
Last Name:BALOY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 12TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1774
Mailing Address - Country:US
Mailing Address - Phone:319-351-1949
Mailing Address - Fax:
Practice Address - Street 1:501 12TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-1774
Practice Address - Country:US
Practice Address - Phone:319-351-1949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health