Provider Demographics
NPI:1689724429
Name:BALMER, VELVET CHRISTINE (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:VELVET
Middle Name:CHRISTINE
Last Name:BALMER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:VELVET
Other - Middle Name:CHRISTINE
Other - Last Name:HURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:IL
Mailing Address - Zip Code:62560-0094
Mailing Address - Country:US
Mailing Address - Phone:217-229-4263
Mailing Address - Fax:217-229-4263
Practice Address - Street 1:207 S. MCELROY ST.
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:IL
Practice Address - Zip Code:62560-0094
Practice Address - Country:US
Practice Address - Phone:217-229-4263
Practice Address - Fax:217-229-4263
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist