Individual
MR. DINO DOMINIC BALLIVIERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, CTTS
Contact information
Practice address
71338 HWY. 21, SUITE 101, COVINGTON, LA 70433-7162
(985) 624-2942
(985) 231-1373
Mailing address
203 LEEDS ST, SLIDELL, LA 70461-5061
(985) 643-3669
(985) 643-3669
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2732
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC2732
PROFESSIONAL LICENSE
LA
Enumeration date
02/15/2009
Last updated
06/20/2020
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