Provider Demographics
NPI:1356820344
Name:BALL, DAVID (MS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BALL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312A WILSON PIKE CIR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2743
Mailing Address - Country:US
Mailing Address - Phone:310-422-9371
Mailing Address - Fax:
Practice Address - Street 1:312A WILSON PIKE CIR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2743
Practice Address - Country:US
Practice Address - Phone:310-422-9371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor