Individual
MS. BRONWEN B. BALLOU
Active
Individual
MS. BRONWEN B. BALLOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
949
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007467
—
VT
01
—
14Y000923NH01
BCBS OF NH
—
05
—
30420957
—
NH
01
—
400420
MVP
—
01
—
49549
MAGELLAN
—
01
—
7728098
AETNA
—
Enumeration date
03/17/2007
Last updated
07/08/2007
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