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General NPI Number Information
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NPI Number | 1013338698
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Entity Type | Individual
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Provider Name | KIMBERLY ANN HALL LCSW/LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/26/2013
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 3798 JANES RD STE 20
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City | ARCATA
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State | CA
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Zip | 95521
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Country | US
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Telephone | 707-825-4963
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Fax | 707-826-8239
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Provider Business Mailing Address
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Address Line | 3507 SPEAR AVE
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City | ARCATA
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State | CA
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Zip | 95521-4833
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Country | US
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Telephone | 707-845-4788
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Fax | 707-826-8239
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW0000008759
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License Number State | TN
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