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1649890997
DERIQUE BALLARD
WESTAMPTON, NJ
NPI
1649890997
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2020-04-16
Last Update Date
2020-04-16
Business Address
DERIQUE BALLARD
770 WOODLANE RD
WESTAMPTON, NJ 08060-3804
Phone number: 609-267-5928
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Mailing Address
DERIQUE BALLARD
770 WOODLANE RD
WESTAMPTON, NJ 08060-3804
Phone number: 609-267-5928
Copy
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