PHILLIP BALLASCH

MODESTO, CA
NPI1417470154
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  B1211161326)
Enumeration Date2017-07-25
Last Update Date2017-07-25
Business Address
PHILLIP BALLASCH
251 E HACKETT RD
MODESTO, CA 95358-9800
Phone number: 209-558-1815
Mailing Address
PHILLIP BALLASCH
3132 HONEY BEE CT
MODESTO, CA 95356-0116
Phone number:
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