Provider Demographics
NPI:1841719952
Name:BALMASEDA, KATHERINE
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:BALMASEDA
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 1:3 BIGELOW RD
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-1849
Mailing Address - Country:US
Mailing Address - Phone:708-748-2315
Mailing Address - Fax:
Practice Address - Street 1:3 BIGELOW RD
Practice Address - Street 2:
Practice Address - City:PARK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60466-1849
Practice Address - Country:US
Practice Address - Phone:708-748-2315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-11
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist