Provider Demographics
NPI:1932836889
Name:BALLOU, DEBORAH E
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:E
Last Name:BALLOU
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 1:1565 POTOMAC HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4663
Mailing Address - Country:US
Mailing Address - Phone:240-346-4791
Mailing Address - Fax:
Practice Address - Street 1:1565 POTOMAC HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4663
Practice Address - Country:US
Practice Address - Phone:240-346-4791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant