Ballard, Latisha Dianne

Ballard, Latisha Dianne is an individual health care provider with primary practice located at 222 E Main St Ste 117 , Barstow CA 92311-2365. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Ballard, Latisha Dianne can be contacted via phone (760) 255-1496.

Contact Information

Primary practice address
222 E Main St Ste 117 Barstow CA 92311-2365
Phone: (760) 255-1496
Fax: (760) 255-2542
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 3171 California
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 92717 California

Profile Details

NPI number 1487173001
LBN Legal business name Ballard, Latisha Dianne
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2017
Last updated Jun 19th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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