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Individual

MS. MONICA BALLARD-BOOTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LSW

Contact information

Practice address
331 STATE ST, SUITE 300, MADISON, WV 25130-1367
(304) 369-5283
(304) 369-4800
Mailing address
331 STATE ST, SUITE 300, MADISON, WV 25130-1367
(304) 369-5283
(304) 369-4800

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1135
WV
104100000X
Social Worker
AP00941739
WV

Other

Enumeration date
07/27/2016
Last updated
07/27/2016
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