Individual
WENDY E BALLIET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1193
SC
103TC0700X
Clinical Psychologist
Primary
1193
SC
Other
Enumeration date
08/18/2011
Last updated
06/25/2018
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