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NPI Profile for SHANIYA N BALLESTERO in DEARBORN, MI.
A broad category grouping different kinds of technologists and technicians. See individual definitions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Technician/Technologist |
156F00000X | |||
Clinical Child & Adolescent |
103TC2200X | 62 | Psychologist, Clinical |
| NPI # | 1861118077 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 10/19/2022 | |
| Last updated | 10/19/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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SHANIYA N BALLESTERO
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SHANIYA N BALLESTERO