Individual
KIMBERLY SUE BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
4450 CASCADE RD SE, GRAND RAPIDS, MI 49546-3633
(616) 949-4975
Mailing address
8736 CASCADE RD SE, ADA, MI 49301-9339
(616) 634-1941
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101004048
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508845066
PORTER HILLS HOME CARE
—
Enumeration date
10/24/2018
Last updated
10/24/2018
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