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NPI Code Detail

MEDICARE: LORI ANN HALE

MEDICARE: LORI ANN HALE
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
1103TC0700XClinical Psychologist6362009213MI
2103TC0700XClinical Psychologist6361007614MI
3106S00000XBehavior Technician

General Provider Information

NPI Number : 1639793011
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI ANN HALE
Provider Business Mailing Address
First Line : 1071 W LANTZ ST
Second Line :
City : DETROIT
State : MI
Zip : 48203-5100
Country : US
Telephone Number : 734-788-6906
Fax Number :
Provider Business Practice Location Address
First Line : 29451 GREENFIELD RD
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48076-2251
Country : US
Telephone Number : 248-864-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2020
Last Update Date : 02/06/2026

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Directions to “ LORI ANN HALE ” Practice Location

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