Provider Demographics
NPI:1962290924
Name:BALANCED WOMEN'S WELLNESS
Entity type:Organization
Organization Name:BALANCED WOMEN'S WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, MSCP
Authorized Official - Phone:860-367-2691
Mailing Address - Street 1:220 STANAVAGE RD
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-2033
Mailing Address - Country:US
Mailing Address - Phone:860-367-2691
Mailing Address - Fax:
Practice Address - Street 1:220 STANAVAGE RD
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-2033
Practice Address - Country:US
Practice Address - Phone:860-367-2691
Practice Address - Fax:860-600-9885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty