Provider Demographics
NPI:1740069228
Name:BALL, EMMA ROSE (MS, CF-SLP)
Entity type:Individual
Prefix:MS
First Name:EMMA
Middle Name:ROSE
Last Name:BALL
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-1706
Mailing Address - Country:US
Mailing Address - Phone:856-345-8889
Mailing Address - Fax:
Practice Address - Street 1:600 W VALLEY FORGE RD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1571
Practice Address - Country:US
Practice Address - Phone:610-337-1775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPSL002275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist