Jennifer Ann Ball, MSCCCSLP

Individual provider Active NPI Speech-Language Pathologist · Hurricane, WV

NPI 1710035563 · NPPES record last updated Oct 2, 2013

Key facts

NPI
1710035563
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP1046 (WV)
Practice address
179 Station Place Way
Hurricane, WV 25526-8747
Phone
(304) 760-6300
Fax
(304) 201-5123
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
SP1046WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Milestones Physical Therapy, Inc. Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP1046 WV Yes

Addresses

Primary practice location

179 Station Place Way
Hurricane, WV 25526-8747

Mailing address

PO Box 450
Scott Depot, WV 25560-0450
Phone (304) 760-6300

Other identifiers

IdentifierTypeStateIssuer
3810008288MedicaidWV
001911418OtherWVBLUE CROSS BLUE SHIELD

Other providers in Hurricane, WV

All providers in Hurricane, WV · Speech-Language Pathologist in West Virginia

Sources for this page

Verify at the official NPI Registry.