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General NPI Number Information
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NPI Number | 1003052564
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Entity Type | Individual
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Provider Name | KELSEY JAMES HALL
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Gender | Female
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 2118 SANDY LN
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City | LAUREL
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State | MS
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Zip | 39443-9087
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Country | US
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Telephone | 601-342-2923
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Fax |
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Provider Business Mailing Address
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Address Line | 530 SHARON MOSS RD
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City | LAUREL
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State | MS
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Zip | 39443-0959
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Country | US
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Telephone | 601-498-5578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 112078
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3183
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License Number State | MS
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