Lutissua D Ballard
Clinical Child & Adolescent Psychologist
5930 E Pima St Suite 200
Tucson
, Arizona 85712-4370
Lutissua D Ballard
Clinical Child & Adolescent Psychologist
5930 E Pima St Suite 200
Tucson
, Arizona 85712-4370
(520) 333-3107
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About
Features
Specialties
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Lutissua D Ballard
- 5930 E Pima St Ste 200
- Tucson, AZ
- Zip : 85712-4370
- Fax : (520) 333-3107
- Phone : (520) 329-1579
Second Address
- Lutissua D Ballard
- 5930 E Pima St Suite 200
- Tucson, AZ
- Zip : 85712-4370
- Phone : (520) 329-1579
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 4480 | AZ |
National Provider Identifier
| NPI | 1093135659 |
|---|---|
| Provider Name | Lutissua D Ballard |
| First Address | Tucson, AZ 85712-4370 |
| Second Address | Tucson, AZ 85712-4370 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/04/2014 |
| Last Update Date | 06/09/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 914097 | (05) | AZ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.