Individual
MR. ANTHONY WADE BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.A.S.
Contact information
Practice address
1015 NORTH ST, YREKA, CA 96097-2233
(309) 176-7745
Mailing address
1015 NORTH ST, YREKA, CA 96097-2233
(309) 917-6774
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
B1205182016
CA
Other
Enumeration date
06/07/2012
Last updated
06/16/2025
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