| Doctor Name: | DR. SHEILA A BALOG |
| NPI Number: | 1073608360 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PS1287 |
| Business Practice Address: | 55 Jonesboro St Mcdonough, GA - 302533164 |
| Business Phone Number: | 6785923792 |
| Business Fax Number: | 6784321397 |
| Mailing Address: | 55 Jonesboro St, MCDONOUGH |
| State: | GA |
| Postal Code: | 302533164 |
| Phone Number: | 6785923792 |
| Fax Number: | 6784321397 |
| NPI Enumeration Date: | 10/04/2006 |
| NPI Last Update Date: | 07/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PS1287 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |