Individual
RAE ANN ELEANOR BALLESTEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW,LSSW
Contact information
Practice address
4821 AMERICAN WAY STE 315, MEMPHIS, TN 38118-2454
(901) 515-6367
Mailing address
PO BOX 1442, COLLIERVILLE, TN 38027-1442
(915) 274-5353
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M9977
MS
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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