Provider Demographics
NPI:1285160234
Name:BALL, KAYLENE (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:KAYLENE
Middle Name:
Last Name:BALL
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12319 N MOPAC EXPY
Mailing Address - Street 2:BUILDING C #300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2414
Mailing Address - Country:US
Mailing Address - Phone:512-454-0341
Mailing Address - Fax:
Practice Address - Street 1:12319 N MOPAC EXPY
Practice Address - Street 2:BUILDING C #300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2414
Practice Address - Country:US
Practice Address - Phone:512-454-0341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80863231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist