Provider Demographics
NPI:1477017184
Name:BALL, AMELIA (OTR)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:BALL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 BEE CAVES RD APT 220
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5606
Mailing Address - Country:US
Mailing Address - Phone:505-400-3099
Mailing Address - Fax:
Practice Address - Street 1:2611 BEE CAVES RD APT 220
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5606
Practice Address - Country:US
Practice Address - Phone:505-400-3099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-27
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117410225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist