Provider Demographics
NPI:1154985349
Name:BALBIN, SARA MARIA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MARIA
Last Name:BALBIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46400 BLUE MOON RD
Mailing Address - Street 2:
Mailing Address - City:DRUMMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54832-4450
Mailing Address - Country:US
Mailing Address - Phone:715-798-3848
Mailing Address - Fax:
Practice Address - Street 1:502 MAIN ST W
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-1554
Practice Address - Country:US
Practice Address - Phone:715-682-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist