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General NPI Number Information
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NPI Number | 1801124375
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Entity Type | Individual
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Provider Name | TANA CATHERYN HALL LPC
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Gender | Female
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Dates
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Enumeration Date | 11/21/2009
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Last Update Date | 11/21/2009
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Provider Practice Location Address
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Address Line | 558 MEDLOCK RD SUITE B
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City | DECATUR
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State | GA
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Zip | 30030-6603
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Country | US
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Telephone | 404-245-5797
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Fax |
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Provider Business Mailing Address
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Address Line | 718 DALEROSE AVE
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City | DECATUR
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State | GA
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Zip | 30030-3934
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Country | US
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Telephone | 404-245-5797
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC004177
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License Number State | GA
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