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General NPI Number Information
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NPI Number | 1104035856
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Entity Type | Individual
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Provider Name | LAURA L HALL LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 983 W MAIN ST STE B
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City | VERNAL
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State | UT
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Zip | 84078-2433
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Country | US
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Telephone | 435-219-9967
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Fax |
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Provider Business Mailing Address
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Address Line | 197 N 1150 W
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City | VERNAL
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State | UT
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Zip | 84078-3331
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Country | US
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Telephone | 435-219-9967
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5335992-3501
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License Number State | UT
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