| NPI | 1295494235 |
|---|---|
| Former Name | NICOLE BALLINGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AR PLSW5511) |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2023-01-04 |