Provider Demographics
NPI:1639633969
Name:BALUHA, KEVIN P
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:P
Last Name:BALUHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 BIGBEE HIGH RD
Mailing Address - Street 2:
Mailing Address - City:WARD
Mailing Address - State:CO
Mailing Address - Zip Code:80481-9630
Mailing Address - Country:US
Mailing Address - Phone:727-698-7558
Mailing Address - Fax:
Practice Address - Street 1:60 BIGBEE HIGH RD
Practice Address - Street 2:
Practice Address - City:WARD
Practice Address - State:CO
Practice Address - Zip Code:80481-9630
Practice Address - Country:US
Practice Address - Phone:727-698-7558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor