Healthcare Provider Details

I. General information

NPI: 1083554885
Provider Name (Legal Business Name): SHAKIA HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 ROBERTA AVE
DOVER DE
19901-4612
US

IV. Provider business mailing address

634 ROBERTA AVE
DOVER DE
19901-4612
US

V. Phone/Fax

Practice location:
  • Phone: 216-236-9004
  • Fax:
Mailing address:
  • Phone: 216-236-9004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: