Provider Demographics
NPI:1003094186
Name:NORTON HALL, JACKIE
Entity Type:Individual
Prefix:MRS
First Name:JACKIE
Middle Name:
Last Name:NORTON HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1785
Mailing Address - Country:US
Mailing Address - Phone:606-677-1166
Mailing Address - Fax:606-451-3386
Practice Address - Street 1:129 PARK AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1785
Practice Address - Country:US
Practice Address - Phone:606-677-1166
Practice Address - Fax:606-451-3386
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency