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Organization

EVOLVE EARLY INTERVENTION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KASIE BALLARD MS, OTR/L (OWNER/OCCUPATIONAL THERAPIST)
(812) 228-6896
Entity
Organization

Contact information

Practice address
2480H US 41 N STE 80, HENDERSON, KY 42420-2359
(812) 228-6896
(270) 212-0271
Mailing address
4101 RODENBERG AVE, EVANSVILLE, IN 47720-6230
(812) 228-6896
(270) 212-0271

Taxonomy

Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
222Q00000X
Developmental Therapist
2251P0200X
Pediatric Physical Therapist
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist
251E00000X
Home Health Agency
Primary

Other

Enumeration date
10/20/2021
Last updated
11/04/2021
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