MEDICARE: XZAVIER ALEXANDER 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
1	103K00000X	Behavior Analyst	LBA002538	GA

General Provider Information

NPI Number	:	1811624075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XZAVIER ALEXANDER HALL

Provider Business Mailing Address
First Line	:	70 TREVITT DR APT C
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-7266
Country	:	US
Telephone Number	:	478-223-3121
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 TREVITT DR APT C
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-7266
Country	:	US
Telephone Number	:	478-223-3121
Fax Number	:

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

Provider Enumeration Date	:	08/06/2022
Last Update Date	:	04/06/2026

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Directions to “ XZAVIER ALEXANDER HALL ” Practice Location

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