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KELLY JONES BALL M.ED., CCC-SLP
>> Speech-Language Pathologist >> Speech, Language and Hearing Service ProvidersRegistrant NPI Number: 1396737946
Individual Registrant: KELLY JONES BALL M.ED., CCC-SLP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
3615 BRASELTON HWY SUITE 103 DACULA, GA 30019-5907 US
Tel: 678-377-9634 Fax: 678-377-9609
Tel: 678-377-9634 Fax: 678-377-9609
Contact information for business:
3615 BRASELTON HWY SUITE 103 DACULA, GA 30019-5907 US
Tel: 678-377-9634 Fax: 678-377-9609
Tel: 678-377-9634 Fax: 678-377-9609
Registration Information:
NPI: 1396737946
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | GA | SLP004955 |
| N | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | NC | 4664 |
| N | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | AK | 33 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD | 52006531-001 | GA | 01 |
| 306024 | GA | 05 | |
| AETNA | 7411355 | GA | 01 |
| 10033353 | GA | 05 |
