| Doctor Name: | JEFFREY BLAKE BALLOU |
| NPI Number: | 1013087675 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCP, LP |
| License Number: | 591-125 |
| Business Practice Address: | 2231 Catlin Ave Superior, WI - 548805137 |
| Business Phone Number: | 7153944173 |
| Business Fax Number: | 7153949182 |
| Mailing Address: | 1320 W Clairemont Ave, Ste 200 EAU CLAIRE |
| State: | WI |
| Postal Code: | 547014566 |
| Phone Number: | 7158342046 |
| Fax Number: | 7158347563 |
| NPI Enumeration Date: | 11/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 591-125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |