Healthcare Provider Details

I. General information

NPI: 1538747282
Provider Name (Legal Business Name): GEORGIA ABIGAIL HALL BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GEORGIA ABIGAIL LOVING BCBA

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 N MAIN ST
KILMARNOCK VA
22482-3822
US

IV. Provider business mailing address

840 FALLIN TOWN RD
WARSAW VA
22572-3325
US

V. Phone/Fax

Practice location:
  • Phone: 804-581-0008
  • Fax: 804-404-9550
Mailing address:
  • Phone: 804-580-0783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-46570
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: