| Doctor Name: | DR. AMANDA D BALL |
| NPI Number: | 1003116112 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D |
| License Number: | |
| Business Practice Address: | 808 S Eldorado Rd Ste 102 Bloomington, IL - 617046071 |
| Business Phone Number: | 3097063190 |
| Business Fax Number: | 3095884115 |
| Mailing Address: | 808 S Eldorado Rd, Ste 102 BLOOMINGTON |
| State: | IL |
| Postal Code: | 617046071 |
| Phone Number: | 3097063190 |
| Fax Number: | 3095884115 |
| NPI Enumeration Date: | 10/25/2010 |
| NPI Last Update Date: | 12/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |