Provider Demographics
NPI:1639278336
Name:BALL, KATHERINE MARSHALL (MS)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MARSHALL
Last Name:BALL
Suffix:
Gender:F
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:HC 65 BOX 39A
Mailing Address - Street 2:
Mailing Address - City:TALCOTT
Mailing Address - State:WV
Mailing Address - Zip Code:24981-9221
Mailing Address - Country:US
Mailing Address - Phone:304-646-1082
Mailing Address - Fax:
Practice Address - Street 1:HC 65 BOX 39A
Practice Address - Street 2:
Practice Address - City:TALCOTT
Practice Address - State:WV
Practice Address - Zip Code:24981-9221
Practice Address - Country:US
Practice Address - Phone:304-646-1082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV574103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9480086000Medicaid