Healthcare Provider Details

I. General information

NPI: 1497111777
Provider Name (Legal Business Name): DR. TRINA HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2016
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8585 N STEMMONS FWY STE 525S
DALLAS TX
75247-3842
US

IV. Provider business mailing address

8585 N STEMMONS FWY STE 525S
DALLAS TX
75247-3842
US

V. Phone/Fax

Practice location:
  • Phone: 205-901-2494
  • Fax:
Mailing address:
  • Phone: 205-901-2494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number36920
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number36920
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: