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General NPI Number Information
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NPI Number | 1962869784
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Entity Type | Organization
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Legal Business Name | RACHAEL HALL, LLC
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 01/25/2016
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Provider Practice Location Address
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Address Line | 8310 PURPLE SAGE RD
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City | MIDDLETON
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State | ID
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Zip | 83644-5313
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Country | US
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Telephone | 208-830-7781
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Fax |
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Provider Business Mailing Address
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Address Line | 8310 PURPLE SAGE RD
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City | MIDDLETON
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State | ID
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Zip | 83644-5313
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Country | US
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Telephone | 208-830-7781
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RACHAEL HALL
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Credential | LCPC
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Telephone | 208-830-7781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCPC-3922
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License Number State | ID
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