Individual
KAY COLLINS BALLINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
4857 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1331
(304) 766-6700
(304) 766-6118
Mailing address
4857 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1331
(304) 766-6700
(304) 766-6118
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
737
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1111000000
—
WV
Enumeration date
09/22/2006
Last updated
07/09/2007
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