Provider Demographics
NPI:1801467303
Name:BALL, DENISE (BA)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:BALL
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 MITCHELL AVE UNIT 604
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2730
Mailing Address - Country:US
Mailing Address - Phone:609-733-2533
Mailing Address - Fax:
Practice Address - Street 1:505 MITCHELL AVE UNIT 604
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2730
Practice Address - Country:US
Practice Address - Phone:609-733-2533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJBA000004302022106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst