Provider Demographics
NPI:1912271347
Name:BALLIER, WANDA TURNER (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:WANDA
Middle Name:TURNER
Last Name:BALLIER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 SERANTINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-2140
Mailing Address - Country:US
Mailing Address - Phone:504-361-6089
Mailing Address - Fax:504-361-6254
Practice Address - Street 1:4422 GEN MEYER AVE # 70131
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-3588
Practice Address - Country:US
Practice Address - Phone:504-361-6089
Practice Address - Fax:504-361-6254
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1476101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional