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Organization
EELSSEN INTERNATIONAL, LLC
Active
Organization
EELSSEN INTERNATIONAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES M. BALLARD, III PHD (OWNER PSYCHOLOGIST)
(410) 361-0658
Entity
Organization
Contact information
Practice address
4200 FORBES BLVD STE 202, LANHAM, MD 20706-4829
(410) 361-0658
(410) 647-7931
Mailing address
PO BOX 281, ODENTON, MD 21113-0281
(410) 361-0658
(410) 647-7931
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7308914
AETNA
—
Enumeration date
07/10/2007
Last updated
07/10/2007
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