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1952047748
TEDRA SHANISE BALLARD
VIRGINIA BEACH, VA
NPI
1952047748
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: VA 0906012260)
Enumeration Date
2022-05-05
Last Update Date
2023-10-03
Business Address
Miss TEDRA SHANISE BALLARD MSW
509 OLD GREAT NECK RD STE 203
VIRGINIA BEACH, VA 23454-3358
Phone number: 757-520-1312
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Mailing Address
Miss TEDRA SHANISE BALLARD MSW
509 OLD GREAT NECK RD STE 203
VIRGINIA BEACH, VA 23454-3358
Phone number:
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