Provider Demographics
NPI:1730198623
Name:BALL, AMY JO (MA, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JO
Last Name:BALL
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9040 EXECUTIVE PARK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4630
Mailing Address - Country:US
Mailing Address - Phone:865-607-4598
Mailing Address - Fax:865-769-0801
Practice Address - Street 1:9040 EXECUTIVE PARK DR STE 102
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4630
Practice Address - Country:US
Practice Address - Phone:865-607-4598
Practice Address - Fax:865-769-0801
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP 0000003012235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist