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General NPI Number Information
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NPI Number | 1639607989
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Entity Type | Individual
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Provider Name | JEANELLA ALLS HALL
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Gender | Female
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 05/31/2017
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Provider Practice Location Address
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Address Line | 865 DEWEY JOHNSON WAY
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City | GRETNA
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State | FL
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Zip | 32332-2311
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Country | US
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Telephone | 850-556-7401
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Fax |
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Provider Business Mailing Address
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Address Line | 865 DEWEY JOHNSON WAY
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City | GRETNA
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State | FL
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Zip | 32332-2311
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Country | US
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Telephone | 850-556-7404
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Fax | 850-627-1065
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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