Provider Demographics
NPI:1629035381
Name:BALSARA, SILVIA NATASHA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SILVIA
Middle Name:NATASHA
Last Name:BALSARA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5111 ROGERS AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-2047
Mailing Address - Country:US
Mailing Address - Phone:479-462-3828
Mailing Address - Fax:240-352-8326
Practice Address - Street 1:5111 ROGERS AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-2047
Practice Address - Country:US
Practice Address - Phone:479-462-3828
Practice Address - Fax:240-352-8326
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9310028101YM0800X
ARM9710005106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist