Jill Ballantyne
Individual provider Active NPI Developmental Therapist · Crestview, FL
NPI 1437814464 · NPPES record last updated Aug 22, 2022
Key facts
- NPI
- 1437814464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 6270 Evan Cir
Crestview, FL 32536-4398 - Phone
- (608) 387-5693
- NPI assigned
- Nov 4, 2021
- Reactivated
- Aug 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Always Hope Developmental Services | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
6270 Evan Cir
Crestview, FL 32536-4398
Mailing address
6270 Evan Cir
Crestview, FL 32536-4398
Phone (608) 387-5693
Other names
- Jill Leaders
Other providers in Crestview, FL
- Amber Kristina Aull
- Kaitlen Autrey
- Muhammad Azzam Awan
- Monica L Baker
- Connie Dennise Baldwin
- Shannon Rae Banaszak
- Glenn M Bankert
- Beverly H. Barbarisi
- Barbee Medical Group LLC
- Kimberly Barberree
All providers in Crestview, FL · Developmental Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.