Individual
DOMINIQUE MARIE BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2148 UPTON AVE, TOLEDO, OH 43607-1645
(567) 377-3932
Mailing address
2148 UPTON AVE, TOLEDO, OH 43607-1645
(567) 377-3932
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082461
—
OH
Enumeration date
10/20/2022
Last updated
04/01/2024
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