Lydia Ballenger
Dietitian, Registered in Indianapolis, IN. Individual provider (NPI-1).
NPI number1982178463
StatusActive
Last updated in NPPESJan 17, 2019
Details
- NPI
- 1982178463
- Entity type
- Individual (NPI-1)
- Name
- Lydia Ballenger
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 17, 2019
- Last updated
- Jan 17, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 37001780A | IN | Yes |
Practice location
566 Ironridge CtIndianapolis, IN 46239-8890
Phone 765-506-0376
Mailing address
566 Ironridge CtIndianapolis, IN 46239-8890
Phone 765-506-0376
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