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Individual

LAURA M BALLENGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
517 S COIT ST, FLORENCE, SC 29501-5220
(843) 407-1565
(843) 407-6748
Mailing address
517 S COIT ST, FLORENCE, SC 29501-5220
(843) 407-1565
(843) 407-6748

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5283
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
376241
SC
Enumeration date
05/17/2007
Last updated
05/29/2013
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