Individual
DOLORES BALLARD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
65 OLD SPRINGFIELD RD, LEBANON, KY 40033-9185
(270) 692-2509
(270) 692-2592
Mailing address
65 OLD SPRINGFIELD RD, LEBANON, KY 40033-9185
(270) 692-2509
(270) 692-2592
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1664
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11489631
CAQH
—
05
—
30605018
—
KY
Enumeration date
06/03/2006
Last updated
07/08/2007
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