MEDICARE: DASHAWN MISCHELLE 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1831961861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DASHAWN MISCHELLE HALL

Provider Business Mailing Address
First Line	:	8243 HUNTINGTON ST
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48185-1643
Country	:	US
Telephone Number	:	313-673-3014
Fax Number	:

Provider Business Practice Location Address
First Line	:	8243 HUNTINGTON ST
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48185-1643
Country	:	US
Telephone Number	:	313-673-3014
Fax Number	:

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

Provider Enumeration Date	:	10/24/2023
Last Update Date	:	10/25/2023

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Directions to “ DASHAWN MISCHELLE HALL ” Practice Location

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