Individual
LYDIA BALLENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
566 IRONRIDGE CT, INDIANAPOLIS, IN 46239-8890
(765) 506-0376
Mailing address
566 IRONRIDGE CT, INDIANAPOLIS, IN 46239-8890
(765) 506-0376
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001780A
IN
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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