Provider Demographics
NPI:1649851304
Name:BALL, ABIGAIL ELIZABETH (SLP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ELIZABETH
Last Name:BALL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6705 W 12TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-1568
Mailing Address - Country:US
Mailing Address - Phone:501-603-9976
Mailing Address - Fax:
Practice Address - Street 1:6705 W 12TH ST STE 3
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1568
Practice Address - Country:US
Practice Address - Phone:501-603-9976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR200956235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist