=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821219304
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HALL AND ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 410 RIDGECREST RD
-----------------------------------------------------
City | ELIZABETHTOWN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42701-9150
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-735-9010
-----------------------------------------------------
Fax | 270-735-9010
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 410 RIDGECREST RD
-----------------------------------------------------
City | ELIZABETHTOWN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42701-9150
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-735-9010
-----------------------------------------------------
Fax | 270-735-9010
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH THERAPIST
-----------------------------------------------------
Name | MS. KARI BONNETT HALL I
-----------------------------------------------------
Credential | MSCCCSLP
-----------------------------------------------------
Telephone | 270-735-9010
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1557
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------