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NPI Code Detail

MEDICARE: ANGELA LEE HALL

MEDICARE: ANGELA LEE HALL
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1578155206
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA LEE HALL
Provider Business Mailing Address
First Line : 8283 OFFICE PARK DR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-2032
Country : US
Telephone Number : 810-321-3001
Fax Number :
Provider Business Practice Location Address
First Line : 8283 OFFICE PARK DR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-2032
Country : US
Telephone Number : 810-321-3001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2021
Last Update Date : 02/04/2021

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Directions to “ ANGELA LEE HALL ” Practice Location

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