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NPI Code Detail

MEDICARE: MS. KATHRYN NAOMI HALL L.P.

MEDICARE: MS. KATHRYN NAOMI HALL L.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling PsychologistLP3782MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2375G3HAOTHERMNBLUE CROSS BLUE SHIELD
3HP45668OTHERMNHEALTH PARTNERS
46267153OTHERMNUBH AND MEDICA
5111201OTHERMNBHP AND UCARE

General Provider Information

NPI Number : 1114091709
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHRYN NAOMI HALL L.P.
Provider Business Mailing Address
First Line : 2115 COUNTY ROAD D E
Second Line : SUITE B
City : MAPLEWOOD
State : MN
Zip : 55109-5353
Country : US
Telephone Number : 651-748-5019
Fax Number : 651-773-7591
Provider Business Practice Location Address
First Line : 2115 COUNTY ROAD D E
Second Line : SUITE B
City : MAPLEWOOD
State : MN
Zip : 55109-5353
Country : US
Telephone Number : 651-748-5019
Fax Number : 651-773-7591
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 07/09/2007

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