Individual
MRS. JUSTINE MARIE BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
7053 S 2310 W, WEST JORDAN, UT 84084-3009
(801) 255-5131
Mailing address
1051 E 560 N, PROVO, UT 84606-2047
(719) 930-5908
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-11-4131
—
Other
Enumeration date
06/28/2011
Last updated
02/13/2012
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