Individual provider · Type 1 NPI
Derique Ballard
Mental Health Counselor · Westampton, NJ
NPI number
1649890997
Active
Practice location
770 Woodlane Rd
Westampton, NJ 08060-3804
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1649890997
Derique Ballard's National Provider Identifier is 1649890997, issued on Apr 16, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Westampton, NJ. The record was last updated on Apr 16, 2020.