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Individual

AMANDA BALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
917 W CANFIELD AVE, COEUR D ALENE, ID 83815-9764
(208) 762-3502
(888) 310-4824
Mailing address
917 W CANFIELD AVE, COEUR D ALENE, ID 83815-9764
(208) 762-3502
(888) 310-4824

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-4295
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1992153282
ID
Enumeration date
05/27/2016
Last updated
05/27/2020
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