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General NPI Number Information
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NPI Number | 1114552643
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Entity Type | Individual
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Provider Name | MEDGINE AUGUSTE HALL BCBA
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Gender | Female
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Dates
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Enumeration Date | 03/04/2020
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 17507 LEE HWY
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City | ABINGDON
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State | VA
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Zip | 24210-7835
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Country | US
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Telephone | 276-525-1338
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Fax |
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Provider Business Mailing Address
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Address Line | 8753 TERRACINA LAKE DR
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City | TAMPA
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State | FL
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Zip | 33625-3011
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Country | US
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Telephone | 941-757-7354
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-20-114018
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-47869
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License Number State | FL
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