| NPI | 1982707279 |
|---|---|
| Professional Name | TAB BALLIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C002121) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 447) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2019-01-22 |