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General NPI Number Information
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NPI Number | 1538301189
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Entity Type | Individual
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Provider Name | TERESE ANN HALL PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2009
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Last Update Date | 03/28/2009
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Provider Practice Location Address
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Address Line | 5272 S LEWIS AVE STE 112
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City | TULSA
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State | OK
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Zip | 74105-6563
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Country | US
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Telephone | 918-695-6092
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Fax | 918-495-2043
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Provider Business Mailing Address
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Address Line | 5272 S LEWIS AVE STE 112
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City | TULSA
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State | OK
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Zip | 74105-6563
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Country | US
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Telephone | 918-695-6092
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Fax | 918-495-2043
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 827
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License Number State | OK
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