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General NPI Number Information
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NPI Number | 1114706322
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Entity Type | Individual
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Provider Name | NYRISHA ANNIE HALL
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Gender | Female
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Dates
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Enumeration Date | 09/26/2023
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 1800 DIAGONAL RD STE 600
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2840
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Country | US
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Telephone | 703-283-6178
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Fax |
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Provider Business Mailing Address
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Address Line | 5113 ROYAL BIRKDALE AVE
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City | WALDORF
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State | MD
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Zip | 20602-5188
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Country | US
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Telephone | 716-880-9630
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0709024954
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0704016357
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License Number State | VA
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