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Individual

MR. EDWARD GEORGE BALLANCE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MACP, MAC, LLPC

Contact information

Practice address
4467 CASCADE RD SE STE 4469, GRAND RAPIDS, MI 49546-3776
(616) 648-3943
Mailing address
4467 CASCADE RD SE STE 4469, GRAND RAPIDS, MI 49546-3776
(616) 648-3943

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401015086
MI

Other

Enumeration date
01/11/2017
Last updated
01/11/2017
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