Individual
MARISSA PAIGE BALLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
85 4TH AVE APT 2J, NEW YORK, NY 10003-5218
(919) 815-6680
Mailing address
85 4TH AVE APT 2J, NEW YORK, NY 10003-5218
Taxonomy
Speciality
Code
Description
License number
State
225600000X
Dance Therapist
Primary
002753-01
NY
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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