Provider Demographics
NPI:1043549355
Name:HALL, DEBRA JANE (LAC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:JANE
Last Name:HALL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1924
Mailing Address - Country:US
Mailing Address - Phone:858-596-5513
Mailing Address - Fax:
Practice Address - Street 1:8 PEARL ST
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-1924
Practice Address - Country:US
Practice Address - Phone:858-596-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist