MEDICARE: SANDRA J HALE MS LPC

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
1	101YP2500X	Professional Counselor	PC001558	PA

General Provider Information

NPI Number	:	1184883373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA J HALE MS LPC

Provider Business Mailing Address
First Line	:	16 PARK AVE
Second Line	:
City	:	E FALLOWFIELD
State	:	PA
Zip	:	19320-4174
Country	:	US
Telephone Number	:	610-384-3107
Fax Number	:

Provider Business Practice Location Address
First Line	:	744 E LINCOLN HWY
Second Line	:	SUITE 410
City	:	COATESVILLE
State	:	PA
Zip	:	19320-3590
Country	:	US
Telephone Number	:	610-380-9982
Fax Number	:	610-380-9987

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	06/03/2008

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