Healthcare Provider Details

I. General information

NPI: 1427120146
Provider Name (Legal Business Name): JENNIFER LYNN HALL M.S., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 KUHL AVE
ORLANDO FL
32806-2006
US

IV. Provider business mailing address

324 REMINGTON DR
OVIEDO FL
32765-6247
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-6144
  • Fax:
Mailing address:
  • Phone: 321-841-6144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY284
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: