Provider Demographics
NPI:1447371190
Name:AJARI, ANN BALFOUR (MSW)
Entity type:Individual
Prefix:MR
First Name:ANN
Middle Name:BALFOUR
Last Name:AJARI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 630
Mailing Address - Street 2:
Mailing Address - City:TAHOE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:96145-0630
Mailing Address - Country:US
Mailing Address - Phone:530-582-3249
Mailing Address - Fax:530-582-3211
Practice Address - Street 1:SIERRA FAMILY SERVICES, INC
Practice Address - Street 2:991 LINCOLN WAY
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603
Practice Address - Country:US
Practice Address - Phone:530-582-3249
Practice Address - Fax:530-582-3211
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4894101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health