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Individual

RICKIA LATRICE BALLENTINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
2431 S ILLINOIS AVE APT 503, CARBONDALE, IL 62903
(773) 378-7922
Mailing address
2431 S ILLINOIS AVE APT 503, CARBONDALE, IL 62903-5931
(773) 378-7922

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
07/16/2025
Last updated
07/16/2025
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