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Individual

ELIZABETH HALEY BALLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
415 PACE ST, MCMINNVILLE, TN 37110-1246
(931) 668-2011
Mailing address
107 MURRAY ESTATES DR, MURRAY, KY 42071-4672
(270) 293-1309

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2443
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2443
STATE LICENSURE NUMBER
TN
Enumeration date
05/03/2015
Last updated
05/03/2015
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