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Individual

MRS. JODIE OLGA BALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, LAC

Contact information

Practice address
4115 BOARDWALK DRIVE, FT. COLLINS, CO 80525
(970) 493-4580
(970) 797-2859
Mailing address
4115 BOARDWALK DRIVE, FT. COLLINS, CO 80525
(970) 493-4580
(970) 797-2859

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LSW.0009921707
CO
1041C0700X
Clinical Social Worker
Primary
LSW.09926250
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000154372
CO
Enumeration date
09/27/2017
Last updated
12/08/2021
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