LATISHA DIANNE BALLARD

BARSTOW, CA
NPI1487173001
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy106H00000X Marriage & Family Therapist
(Licence: CA  92717)
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: CA  3171)
Enumeration Date2017-09-14
Last Update Date2020-06-19
Business Address
LATISHA DIANNE BALLARD
222 E MAIN ST STE 117
BARSTOW, CA 92311-2365
Phone number: 760-255-1496
Mailing Address
LATISHA DIANNE BALLARD
222 E MAIN ST STE 117
BARSTOW, CA 92311-2365
Phone number: 760-255-1496