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NPI Code Detail

MEDICARE: LINA M. HALL PH.D.

MEDICARE: LINA M. HALL PH.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
1103T00000XPsychologist465SD

General Provider Information

NPI Number : 1528121464
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINA M. HALL PH.D.
Provider Business Mailing Address
First Line : 816 E 316TH ST
Second Line :
City : VERMILLION
State : SD
Zip : 57069-7224
Country : US
Telephone Number :
Fax Number : 605-668-3460
Provider Business Practice Location Address
First Line : 3515 BROADWAY AVE
Second Line :
City : YANKTON
State : SD
Zip : 57078-7600
Country : US
Telephone Number : 605-668-3100
Fax Number : 605-668-3460
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 09/15/2010

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