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General NPI Number Information
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NPI Number | 1104268952
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Entity Type | Individual
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Provider Name | MR. CALVIN HALL JR.
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Gender | Male
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 3101 RACKLEY DR
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City | TALLAHASSEE
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State | FL
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Zip | 32305-6737
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Country | US
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Telephone | 850-524-1556
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 RACKLEY DR
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City | TALLAHASSEE
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State | FL
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Zip | 32305-6737
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Country | US
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Telephone | 850-524-1556
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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 | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | FL
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