Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 053735-00 | FL |
NPI | 1881921955 |
---|---|
Provider Name | Cherie Ballard |
First Address | Fort Lauderdale, FL 33306 |
Second Address | Fort Lauderdale, FL 33308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2009 |
Last Update Date | 11/11/2009 |