Individual
DR. TABITHA DELAINA BALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1001 VIRGINIA AVE STE 210, HAPEVILLE, GA 30354-1367
(404) 218-8657
Mailing address
3645 MARKETPLACE BLVD STE 130-669, EAST POINT, GA 30344-5747
(404) 217-8657
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0810004529
VA
103T00000X
Psychologist
PSY003839
GA
103TB0200X
Cognitive & Behavioral Psychologist
PSY003839
GA
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003183738C
—
GA
Enumeration date
10/02/2009
Last updated
09/28/2021
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