Provider Demographics
NPI:1235940982
Name:BALANCED CHEMISTRY, PLLC
Entity type:Organization
Organization Name:BALANCED CHEMISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAILLOUX
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:789-285-9187
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:MA
Mailing Address - Zip Code:01005-0021
Mailing Address - Country:US
Mailing Address - Phone:978-285-9187
Mailing Address - Fax:508-213-3982
Practice Address - Street 1:7 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:MA
Practice Address - Zip Code:01005-8726
Practice Address - Country:US
Practice Address - Phone:978-285-9187
Practice Address - Fax:508-213-3982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty