| NPI | 1861118077 |
|---|---|
| Other Name | SHANIYA NICOLE BALLESTERO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156F00000X Technician/Technologist |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2022-10-19 |