Provider Demographics
NPI:1063857282
Name:DR. RONNETTE P. BALLARD, LICENSED PSYCHOLOGIST
Entity Type:Organization
Organization Name:DR. RONNETTE P. BALLARD, LICENSED PSYCHOLOGIST
Other - Org Name:INSIGHT PSYCHOLOGY AND BEHAVIORAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:512-704-8349
Mailing Address - Street 1:103 12TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3960
Mailing Address - Country:US
Mailing Address - Phone:512-704-8349
Mailing Address - Fax:
Practice Address - Street 1:103 12TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3960
Practice Address - Country:US
Practice Address - Phone:512-704-8349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34216103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty