Provider Demographics
NPI:1942352620
Name:BALZARETT, CATHERINE OLIVIA (RN, MS, APN-BC)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:OLIVIA
Last Name:BALZARETT
Suffix:
Gender:F
Credentials:RN, MS, APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10102 SANDERS CT
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-2541
Mailing Address - Country:US
Mailing Address - Phone:703-759-2596
Mailing Address - Fax:
Practice Address - Street 1:8206 LEESBURG PIKE
Practice Address - Street 2:SUITE 207
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2614
Practice Address - Country:US
Practice Address - Phone:703-893-8586
Practice Address - Fax:703-893-3879
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001101039101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health