Individual
DR. CAROL ANN BALLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
501 CHIPETA WAY, SALT LAKE CITY, UT 84108
(801) 583-2500
Mailing address
501 CHIPETA WAY, SALT LAKE CITY, UT 84108
(801) 483-3068
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2663772501
UT
Other
Enumeration date
03/25/2006
Last updated
07/08/2007
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