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Individual

ANGELA FARAH BALLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
55 HATCHETTS HILL RD, OLD LYME, CT 06371-1534
(800) 370-3651
Mailing address
55 HATCHETTS HILL RD, OLD LYME, CT 06371-1534
(800) 370-3651

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5514
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
005514
CT

Other

Enumeration date
09/30/2013
Last updated
10/12/2017
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