Matthew Ballenger
Counselor in Aurora, IL. Individual provider (NPI-1).
NPI number1316355308
StatusActive
Last updated in NPPESJul 23, 2014
Details
- NPI
- 1316355308
- Entity type
- Individual (NPI-1)
- Name
- Matthew Ballenger
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 23, 2014
- Last updated
- Jul 23, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
70 S River StAurora, IL 60506-5185
Phone 630-844-2662
Mailing address
70 S River StAurora, IL 60506-5185
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