Individual
MS. BRIDGETT BALLISTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7877 WREN AVE, SUITE A, GILROY, CA 95020-4980
(408) 905-6594
Mailing address
230 E DUNNE AVE, APT #1322, MORGAN HILL, CA 95037-4654
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/28/2012
Last updated
10/28/2013
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