Provider Demographics
NPI:1902426869
Name:BALKIND, ERIN O'NEILL (LMBT, RCST)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:O'NEILL
Last Name:BALKIND
Suffix:
Gender:F
Credentials:LMBT, RCST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 MONTICELLO ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-3638
Mailing Address - Country:US
Mailing Address - Phone:336-209-4929
Mailing Address - Fax:
Practice Address - Street 1:1403 SUNSET DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2013
Practice Address - Country:US
Practice Address - Phone:336-209-4929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1537225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist