MEDICARE: ALICIA BLAKE-HALL BSN, RN,RD, CDCES

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	133V00000X	Registered Dietitian	D01031	MD

General Provider Information

NPI Number	:	1568312072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA BLAKE-HALL BSN, RN,RD, CDCES

Provider Business Mailing Address
First Line	:	7795 NOTLEY RD
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-1877
Country	:	US
Telephone Number	:	410-212-7795
Fax Number	:

Provider Business Practice Location Address
First Line	:	7795 NOTLEY RD
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-1877
Country	:	US
Telephone Number	:	410-212-7795
Fax Number	:	410-360-2711

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

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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