Anthony Travon Ballast

NPI #1295391225 in Cheyenne, Wyoming

Provider Information

NPI Number
1295391225
Entity Type
Individual
Name
Anthony Travon Ballast
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Behavior Technician
Enumeration Date
May 15, 2019
Last Updated
May 15, 2019

Practice Location

Address
3120 OLD FAITHFUL RD STE 200
State
Wyoming
ZIP Code
82001-5887
Phone
(307) 221-2937

Specialties & Taxonomy Codes

Specialty
Behavior Technician

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