Provider Demographics
NPI:1144736950
Name:BALLING, HALEY LYNN
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:LYNN
Last Name:BALLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 NE 23RD TER
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-5146
Mailing Address - Country:US
Mailing Address - Phone:772-285-7083
Mailing Address - Fax:
Practice Address - Street 1:840 SE OSCEOLA ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2432
Practice Address - Country:US
Practice Address - Phone:772-285-7083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty