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1811668981
JOHNNIE LEWIS BALOUS
DELTONA, FL
NPI
1811668981
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2021-09-27
Last Update Date
2021-09-27
Business Address
JOHNNIE LEWIS BALOUS MS
1618 AMBOY DR
DELTONA, FL 32738-5202
Phone number: 407-202-2996
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Mailing Address
JOHNNIE LEWIS BALOUS MS
1618 AMBOY DR
DELTONA, FL 32738-5202
Phone number: 407-202-2996
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