Individual
CHRISTINE I VONBALLMOOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2001 W BLUE HERON BLVD, RIVIERA BEACH, FL 33404-5003
(561) 841-3500
Mailing address
2001 W BLUE HERON BLVD, RIVIERA BEACH, FL 33404-5003
(561) 841-3500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SW7407
FL
1041C0700X
Clinical Social Worker
SW7407
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767166100
—
FL
Enumeration date
11/19/2008
Last updated
06/06/2012
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