Individual
HEATHER BALLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
607 NORTH AVE, DOOR 11, WAKEFIELD, MA 01880
(434) 586-6926
Mailing address
412 SOUTH ST, READING, MA 01867-4004
(781) 942-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
380
MA
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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