MEDICARE: DEBORAH LYNNE HALL OTR/L

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	225X00000X	Occupational Therapist	OT10253	FL
2	225X00000X	Occupational Therapist	164019	KY
3	225X00000X	Occupational Therapist	006195	GA

General Provider Information

NPI Number	:	1295093797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH LYNNE HALL OTR/L

Provider Business Mailing Address
First Line	:	739 TEE BOX DR
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30223-7280
Country	:	US
Telephone Number	:	305-962-3120
Fax Number	:	305-962-3120

Provider Business Practice Location Address
First Line	:	5600 COLLINS AVE APT 11P
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2411
Country	:	US
Telephone Number	:	305-865-3111
Fax Number	:	305-865-3111

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

Provider Enumeration Date	:	05/03/2012
Last Update Date	:	05/09/2017

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