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1144581950
ANTHONY WADE BALLARD
REDDING, CA
NPI
1144581950
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA B1205182016)
Enumeration Date
2012-06-07
Last Update Date
2012-06-07
Business Address
Mr. ANTHONY WADE BALLARD R.A.S.
755 LAKE BLVD
REDDING, CA 96003-2235
Phone number: 530-229-1704
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Mailing Address
Mr. ANTHONY WADE BALLARD R.A.S.
755 LAKE BLVD
REDDING, CA 96003-2235
Phone number: 530-229-1704
Copy
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