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Individual

AISHA ABIGAIL BALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
707 LAKE COOK RD, DEERFIELD, IL 60015-5613
(877) 587-2945
Mailing address
707 LAKE COOK RD, DEERFIELD, IL 60015-5613
(877) 586-2945

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
XOG911298208
IL
Enumeration date
12/16/2022
Last updated
12/16/2022
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