Individual
MS. TRACEY BALLAGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 SUMMERDALE LN, EVINGTON, VA 24550-2492
(434) 660-0277
Mailing address
207 SUMMERDALE LN, EVINGTON, VA 24550-2492
(434) 660-0277
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
5575
VA
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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