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NPI Code Detail

MEDICARE: MRS. TARA J HALL LPC

MEDICARE: MRS. TARA J HALL LPC
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
1101YP2500XProfessional Counselor5980OK

General Provider Information

NPI Number : 1851753362
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TARA J HALL LPC
Provider Business Mailing Address
First Line : 8518 S PENNSYLVANIA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-5226
Country : US
Telephone Number : 972-978-2542
Fax Number :
Provider Business Practice Location Address
First Line : 8518 S PENNSYLVANIA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-5226
Country : US
Telephone Number : 972-978-2542
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2016
Last Update Date : 03/23/2016

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