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General NPI Number Information
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NPI Number | 1427823566
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Entity Type | Individual
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Provider Name | GEORGIA N. BALLANTYNE-DURAND MSW
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Gender | Female
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 2701 W OAKLAND PARK BLVD STE 400A
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1389
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Country | US
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Telephone | 305-409-5920
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 669611
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City | POMPANO BEACH
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State | FL
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Zip | 33066-9611
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Country | US
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Telephone | 305-409-5920
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 19246
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License Number State | FL
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