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General NPI Number Information
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NPI Number | 1346052560
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Entity Type | Individual
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Provider Name | DALLIN CARL BALL
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Gender | Male
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 5455 W 11000 N STE 201
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City | HIGHLAND
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State | UT
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Zip | 84003-8820
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Country | US
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Telephone | 801-449-0017
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Fax |
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Provider Business Mailing Address
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Address Line | 582 N 360 W
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City | VINEYARD
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State | UT
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Zip | 84059-4815
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Country | US
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Telephone | 951-235-9692
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14198446-3502
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License Number State | UT
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