NPI 1295494813

Michael Ballard, CRS

Practitioner Peer Specialist Media, PA

Practice location

Address: 206 S Orange St, Media, PA 19063-3679
Phone: (855) 687-2410

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X Licence CRS (PA)

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Registry record

NPI: 1295494813
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Dec 2021
Record last updated: 10 Dec 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.