Provider Demographics
NPI:1558095950
Name:BALL, ZOEE OLYVIA
Entity Type:Individual
Prefix:
First Name:ZOEE
Middle Name:OLYVIA
Last Name:BALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 HOLLY SPRINGS RD STE 111
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9634
Mailing Address - Country:US
Mailing Address - Phone:919-285-2157
Mailing Address - Fax:
Practice Address - Street 1:1140 HOLLY SPRINGS RD STE 111
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9634
Practice Address - Country:US
Practice Address - Phone:919-285-2157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30000923235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC30000923OtherNC TEMPORARY SLP LICENSE FROM NORTH CAROLINA BOARD OF EXAMINERS