Healthcare Provider Details

I. General information

NPI: 1598270225
Provider Name (Legal Business Name): HELEN HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 12/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OLD WEST CHESTER PIKE
HAVERTOWN PA
19083-2712
US

IV. Provider business mailing address

724A BUCK LN
HAVERFORD PA
19041-1202
US

V. Phone/Fax

Practice location:
  • Phone: 610-449-2192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPCO10019
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: