Ballou, Jean D

Ballou, Jean D is an sole proprietor health care provider with primary practice located at 210 N Higgins Ave Ste 314 , Missoula MT 59802-4443. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ballou, Jean D can be contacted via phone (406) 543-9566.

Contact Information

Primary practice address
210 N Higgins Ave Ste 314 Missoula MT 59802-4443
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 27LCSW Montana

Profile Details

NPI number 1699836296
LBN Legal business name Ballou, Jean D
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 13th, 2006
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1699836296 NPPES
Montana MEDICAID 0503295

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