Individual
TIM SCOTT BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
519 S 4TH ST W, MISSOULA, MT 59801-2629
(406) 240-7924
Mailing address
519 S 4TH ST W, MISSOULA, MT 59801-2629
(406) 240-7924
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1154
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0256496
—
MT
01
—
741820
BLUE CROSS BLUE SHIELD
MT
Enumeration date
05/22/2007
Last updated
07/09/2007
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