Individual
EMMA BALLANTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2020 26TH AVE E, BRADENTON, FL 34208-7753
(941) 782-4600
(941) 782-4601
Mailing address
PO BOX 197515, NASHVILLE, TN 37219-7515
(941) 782-4299
(941) 782-4301
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW20496
FL
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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