Individual
SHAZAN BALLOUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSSP
Contact information
Practice address
4507 ACKERMAN ST, NEW PORT RICHEY, FL 34653-5204
(832) 955-7265
Mailing address
4507 ACKERMAN ST, NEW PORT RICHEY, FL 34653-5204
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
72229
TX
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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