Provider Demographics
NPI:1225061401
Name:GAITHER BALL, SUSAN CELESTINE (MED)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CELESTINE
Last Name:GAITHER BALL
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:CELESTINE
Other - Last Name:GAITHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 MCGEE RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-2104
Mailing Address - Country:US
Mailing Address - Phone:864-206-2221
Mailing Address - Fax:
Practice Address - Street 1:200 MCGEE RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-2104
Practice Address - Country:US
Practice Address - Phone:864-206-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor