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1144823675
ANTHONY BALLESTEROS
GREENVILLE, SC
NPI
1144823675
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: SC 20-144776)
Enumeration Date
2020-11-18
Last Update Date
2020-11-18
Business Address
ANTHONY BALLESTEROS
113 WHITSETT ST
GREENVILLE, SC 29601-3138
Phone number: 864-520-1614
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Mailing Address
ANTHONY BALLESTEROS
113 WHITSETT ST
GREENVILLE, SC 29601-3138
Phone number: 864-520-1614
Copy
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