Individual
DIANA M BALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9417 SAINT JOE CENTER RD, FORT WAYNE, IN 46835-9259
(859) 475-3247
Mailing address
10515 HICKORY TREE RD, FORT WAYNE, IN 46845-1023
(859) 475-3247
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6059
—
1041C0700X
Clinical Social Worker
Primary
253974
KY
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000468
—
OH
05
—
1790731081
—
KY
05
—
300063943
—
IN
Enumeration date
09/08/2011
Last updated
12/11/2023
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