Individual
DR. ROGER ASHMAN BALLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LMFT, LPC
Contact information
Practice address
2900 THOMAS AVE S, APARTMENT 1526, MINNEAPOLIS, MN 55416-4477
(651) 246-7592
Mailing address
2900 THOMAS AVE S, APARTMENT 1526, MINNEAPOLIS, MN 55416-4477
(651) 246-7592
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
1130
MN
106H00000X
Marriage & Family Therapist
203
NH
106H00000X
Marriage & Family Therapist
Primary
723
WI
Other
Enumeration date
10/23/2006
Last updated
08/30/2016
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