Individual
TRACI DENISE BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, MPA, LLPC
Contact information
Practice address
79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
(313) 831-5535
(313) 831-2608
Mailing address
79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
(313) 831-5535
(313) 831-2608
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401016840
MI
247200000X
Other Technician
—
—
Other
Enumeration date
08/26/2016
Last updated
02/15/2020
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