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Organization
EVOLVE EARLY INTERVENTION
Active
Organization
EVOLVE EARLY INTERVENTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KASIE BALLARD MS, OTR/L (OWNER/OCCUPATIONAL THERAPIST)
(812) 228-6896
Entity
Organization
Contact information
Practice address
2480H US 41 N STE 80, HENDERSON, KY 42420-2359
(812) 228-6896
(270) 212-0271
Mailing address
4101 RODENBERG AVE, EVANSVILLE, IN 47720-6230
(812) 228-6896
(270) 212-0271
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
NULL
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
—
NULL
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
—
—
222Q00000X
Developmental Therapist
—
NULL
222Q00000X
Developmental Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
NULL
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
NULL
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
10/20/2021
Last updated
11/04/2021
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