| Doctor Name: | DR. KERRY L BALENTINE |
| NPI Number: | 1063518165 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 0101235062 |
| Business Practice Address: | 201 E Grover St Shelby, NC - 281503917 |
| Business Phone Number: | 7044873000 |
| Business Fax Number: | 7044767417 |
| Mailing Address: | 201 E Grover St, SHELBY |
| State: | NC |
| Postal Code: | 281503917 |
| Phone Number: | 7044873000 |
| Fax Number: | 7044767417 |
| NPI Enumeration Date: | 09/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | 0101235062 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |