Provider Demographics
NPI:1124233697
Name:BALODIS-COX, SUSAN RENEE (MA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:RENEE
Last Name:BALODIS-COX
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7981 168TH AVE NE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-0911
Mailing Address - Country:US
Mailing Address - Phone:425-503-9845
Mailing Address - Fax:425-883-9707
Practice Address - Street 1:7981 168TH AVE NE
Practice Address - Street 2:SUITE 208
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-0911
Practice Address - Country:US
Practice Address - Phone:425-503-9845
Practice Address - Fax:425-883-9707
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006374101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health