Provider Demographics
NPI:1114016714
Name:HALL, CHRISTINE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MARIE
Last Name:HALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 CLIFF VALLEY WAY NE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2428
Mailing Address - Country:US
Mailing Address - Phone:404-315-6010
Mailing Address - Fax:
Practice Address - Street 1:1970 CLIFF VALLEY WAY NE
Practice Address - Street 2:SUITE 107
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2428
Practice Address - Country:US
Practice Address - Phone:404-315-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002882103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical