Provider Demographics
NPI:1659165397
Name:BALL, KENDAL EVON
Entity type:Individual
Prefix:
First Name:KENDAL
Middle Name:EVON
Last Name:BALL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 ENZO CT APT 304
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-0094
Mailing Address - Country:US
Mailing Address - Phone:304-239-9710
Mailing Address - Fax:
Practice Address - Street 1:750 ENZO CT APT 304
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-0094
Practice Address - Country:US
Practice Address - Phone:304-239-9710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician