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General NPI Number Information
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NPI Number | 1932034295
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Entity Type | Individual
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Provider Name | KEVIN MATTHEW BALL-DUANE PSYD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 3000 CENTER GREEN DR STE 230
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City | BOULDER
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State | CO
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Zip | 80301-2364
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Country | US
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Telephone | 720-242-7533
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Fax | 720-815-2613
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Provider Business Mailing Address
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Address Line | 35 VAN GORDON ST APT 555
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City | LAKEWOOD
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State | CO
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Zip | 80228-1744
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Country | US
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Telephone |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY.0007059
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License Number State | CO
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