Individual
TARA RENEE BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
616 WADE AVE, RALEIGH, NC 27605-1237
(919) 828-6251
Mailing address
741 BENCHMARK DR, RALEIGH, NC 27615-6331
(919) 828-6251
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3474
NC
Other
Enumeration date
05/20/2008
Last updated
05/20/2008
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