Individual
LILIANE MARIE BALLOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 10TH AVE S, NAMPA, ID 83651-3832
(208) 466-2229
(208) 466-2667
Mailing address
204 10TH AVE S, NAMPA, ID 83651-3832
(208) 466-2229
(208) 466-2667
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-5008
ID
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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