RICHARD BALLOU

MESA, AZ
NPI1194962282
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ  LISAC-0123)
Enumeration Date2009-01-12
Last Update Date2009-01-12
Business Address
-- RICHARD BALLOU LISAC
450 W 5TH PL
MESA, AZ 85201-5619
Phone number: 480-962-7922
Mailing Address
-- RICHARD BALLOU LISAC
1811 S ALMA SCHOOL RD STE 160
MESA, AZ 85210-3001
Phone number: 480-831-7566
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