Provider Demographics
NPI:1841676970
Name:BALL, AUBREY
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:BALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:107 BIRCH HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8207
Mailing Address - Country:US
Mailing Address - Phone:803-528-9384
Mailing Address - Fax:
Practice Address - Street 1:107 BIRCH HOLLOW DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-8207
Practice Address - Country:US
Practice Address - Phone:803-528-9384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5755103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling