FANTA BALLARD

ANAHEIM, CA
NPI1770307621
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  1502920323)
Enumeration Date2024-11-07
Last Update Date2024-11-07
Business Address
FANTA BALLARD
1320 W PEARL ST
ANAHEIM, CA 92801-5941
Phone number: 714-780-1174
Mailing Address
FANTA BALLARD
1320 W PEARL ST
ANAHEIM, CA 92801-5941
Phone number: 714-780-1174
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