Individual
MICHELLE KATHERYN BALLASIOTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4201 LAKE BOONE TRL STE 4, RALEIGH, NC 27607-7511
(919) 781-4434
Mailing address
4201 LAKE BOONE TRL STE 4, RALEIGH, NC 27607-7511
(919) 781-4434
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
15388
NC
225X00000X
Occupational Therapist
Primary
15388
NC
Other
Enumeration date
09/19/2022
Last updated
10/12/2022
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