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Individual
AMANDA L BALLARD
Active
Individual
AMANDA L BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC, SAC-IT, OT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17168-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
18847-130
WI
225X00000X
Occupational Therapist
056008907
IL
225X00000X
Occupational Therapist
103657
MN
225X00000X
Occupational Therapist
5202-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
11/20/2008
Last updated
01/14/2026
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