Provider Demographics
NPI:1063826410
Name:HALL, LAUREN ERIKA (IYD, RYT, MSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ERIKA
Last Name:HALL
Suffix:
Gender:F
Credentials:IYD, RYT, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 E CLEVE BUTCHER RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-9059
Mailing Address - Country:US
Mailing Address - Phone:812-320-4534
Mailing Address - Fax:
Practice Address - Street 1:3635 E CLEVE BUTCHER RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-9059
Practice Address - Country:US
Practice Address - Phone:812-320-4534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical