Provider Demographics
NPI:1972819258
Name:BALLINGER, JONI L (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JONI
Middle Name:L
Last Name:BALLINGER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:SD
Mailing Address - Zip Code:57038-0001
Mailing Address - Country:US
Mailing Address - Phone:712-898-1899
Mailing Address - Fax:
Practice Address - Street 1:3200 G ST
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3339
Practice Address - Country:US
Practice Address - Phone:402-494-3043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1420235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist