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General NPI Number Information
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NPI Number | 1750656062
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Entity Type | Individual
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Provider Name | MARY BETH BALL LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 03/20/2012
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Provider Practice Location Address
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Address Line | 502 RAINIER AVE. S. STE #204
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City | SEATTLE
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State | WA
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Zip | 98144
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Country | US
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Telephone | 206-678-7064
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Fax | 206-325-6516
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Provider Business Mailing Address
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Address Line | 14235 6TH AVE SW
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City | BURIEN
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State | WA
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Zip | 98166-1517
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Country | US
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Telephone | 206-310-0993
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Fax | 206-325-6516
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF00001699
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License Number State | WA
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