Provider Demographics
NPI:1750699781
Name:BALENTINE, KAREM
Entity type:Individual
Prefix:
First Name:KAREM
Middle Name:
Last Name:BALENTINE
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:CALLE OLMO #501 HIGHLAND PARK APARTMENTS
Mailing Address - Street 2:APT # 502
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-649-5189
Mailing Address - Fax:
Practice Address - Street 1:1607 AVE PONCE DE LEON
Practice Address - Street 2:SUITE 301 COBIANS PLAZA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1820
Practice Address - Country:US
Practice Address - Phone:787-649-5189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3703103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling