Healthcare Provider Details
I. General information
NPI: 1730018698
Provider Name (Legal Business Name): SAMANTHA HALL BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
208 RUTH DR
EASLEY SC
29640-2741
US
IV. Provider business mailing address
208 RUTH DR
EASLEY SC
29640-2741
US
V. Phone/Fax
- Phone: 864-982-4201
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-26-89992 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: