Individual
JOANNA LEA BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1175 E MAIN ST STE C1, MEDFORD, OR 97504-7457
(541) 772-0127
Mailing address
715 SW RAMSEY AVE, GRANTS PASS, OR 97527
(541) 772-0127
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
OR
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
05/27/2016
Last updated
07/21/2022
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