Individual
MONICA LOTORIA BALLOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1345 N MAIN ST, DANVILLE, VA 24540-3721
(434) 429-2649
Mailing address
1345 N MAIN ST, DANVILLE, VA 24540-3721
(434) 429-2649
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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