Individual
WHITNEY BALLIETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
187 S CANAAN RD, CANAAN, CT 06018-2544
(860) 824-1397
Mailing address
PO BOX 717, CANAAN, CT 06018-0717
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1038
CT
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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