Individual
TAKIYSHA MCLEOD-BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
726 QUINCY ST FL 4, BROOKLYN, NY 11221-2210
(347) 826-6167
(917) 397-3520
Mailing address
32 W DEAN ST, FREEPORT, NY 11520-2106
(917) 757-2596
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401983
NY
Other
Enumeration date
03/16/2016
Last updated
04/30/2025
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