Jack Patrick Ballum Valid NPI

Individual provider · Addiction (Substance Use Disorder) Counselor · Needles, CA

NPI

1437493483

Type

Individual (Type 1)

Primary specialty

Addiction (Substance Use Disorder) Counselor (Counselor)

Specialty group

Behavioral Health & Social Service Providers

Taxonomy code

101YA0400X

Sex

Male

Sole proprietor

No

Enumerated

2012-11-15

Last updated

2012-11-15