Individual
TINA BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
252 S VETERANS BLVD, TUPELO, MS 38804-5022
(662) 840-3008
(662) 841-3007
Mailing address
1340 GUYTON CIR, WEST POINT, MS 39773-4106
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
W4497
MS
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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