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Individual
STEPHANIE VANESS BALLEW
Active
Individual
STEPHANIE VANESS BALLEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C00729
MI
104100000X
Social Worker
33002992A
IN
106H00000X
Marriage & Family Therapist
35001221A
IN
Other
Enumeration date
02/27/2008
Last updated
02/27/2008
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