Individual
MARISSA JANE BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
36 N DETROIT ST, XENIA, OH 45385-2909
(513) 892-4673
Mailing address
2400 W STROOP RD, KETTERING, OH 45439-2041
(937) 203-8115
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CDCA.181955
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCII.162037
OH
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/06/2022
Last updated
11/21/2024
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