Individual
DANA MICHELLE BALLEWSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY D
Contact information
Practice address
2108 63RD ST, KENOSHA, WI 53143-4454
(262) 652-2406
Mailing address
2108 63RD ST, KENOSHA, WI 53143-4454
(262) 652-2406
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3646
WI
Other
Enumeration date
08/14/2012
Last updated
03/30/2020
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