Provider Demographics
NPI:1477921203
Name:BALL, ROSALIE N (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSALIE
Middle Name:N
Last Name:BALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 8TH AVE NE STE 225
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-3253
Mailing Address - Country:US
Mailing Address - Phone:605-229-3500
Mailing Address - Fax:605-229-3505
Practice Address - Street 1:2301 8TH AVE NE STE 225
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-3253
Practice Address - Country:US
Practice Address - Phone:160-522-9350
Practice Address - Fax:160-522-9350
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-10
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
101YM0800XOtherSIOUX FALLS VA HEALTH CARE SYSTEM
SD390200000XOtherSIOUX FALLS VA HEALTH CARE SYSTEM