Individual
SHANNON BALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 BLUE JAY LOOP, VICTORIA, TX 77905-3298
(361) 676-4154
Mailing address
109 BLUE JAY LOOP, VICTORIA, TX 77905-3298
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
171400000X
Health & Wellness Coach
—
—
Other
Enumeration date
11/11/2025
Last updated
11/14/2025
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