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NPI Code Detail

MEDICARE: MRS. LAURA ANN BALLIET LPC

MEDICARE: MRS. LAURA ANN BALLIET LPC
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
1101Y00000XCounselorCO501211OH

General Provider Information

NPI Number : 1124284807
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA ANN BALLIET LPC
Provider Business Mailing Address
First Line : 622 DOMINIC DR
Second Line :
City : CUYAHOGA FALLS
State : OH
Zip : 44223-3800
Country : US
Telephone Number : 330-928-8519
Fax Number :
Provider Business Practice Location Address
First Line : 230 S COURT ST
Second Line : SUITE 5
City : MEDINA
State : OH
Zip : 44256-2275
Country : US
Telephone Number : 330-723-7977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2008
Last Update Date : 08/01/2008

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Directions to “ MRS. LAURA ANN BALLIET LPC” Practice Location

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