Individual
DR. DIANA BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
510 TRAVIS AVE, STATEN ISLAND, NY 10314-6154
(917) 763-2476
(718) 370-3534
Mailing address
510 TRAVIS AVE, STATEN ISLAND, NY 10314-6154
(917) 763-2476
(718) 370-3534
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
BCCC#0557
NY
Other
Enumeration date
02/06/2017
Last updated
04/21/2017
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