MEDICARE: KAHLEMA BALLARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		GA

General Provider Information

NPI Number	:	1013874783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAHLEMA BALLARD

Provider Business Mailing Address
First Line	:	4344 W HIGHLAND DR APT 85
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31210-5801
Country	:	US
Telephone Number	:	518-898-1455
Fax Number	:

Provider Business Practice Location Address
First Line	:	4344 W HIGHLAND DR APT 85
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31210-5801
Country	:	US
Telephone Number	:	518-898-1455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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Directions to “ KAHLEMA BALLARD ” Practice Location

Language	Start Address	Practice Location

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