Individual
JENNIFER ANN BALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCCSLP
Contact information
Practice address
179 STATION PLACE WAY, HURRICANE, WV 25526-8747
(304) 760-6300
(304) 201-5123
Mailing address
PO BOX 450, SCOTT DEPOT, WV 25560-0450
(304) 760-6300
(304) 201-5123
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1046
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001911418
BLUE CROSS BLUE SHIELD
WV
05
—
3810008288
—
WV
Enumeration date
01/08/2007
Last updated
10/02/2013
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