MEDICARE: AMELIA HALL PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist

General Provider Information

NPI Number	:	1265984298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMELIA HALL PSY.D.

Provider Business Mailing Address
First Line	:	PO BOX 2924
Second Line	:
City	:	LA PLATA
State	:	MD
Zip	:	20646-2984
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8403 COLESVILLE RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-6331
Country	:	US
Telephone Number	:	301-367-4827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2016
Last Update Date	:	07/09/2019

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