Provider Demographics
NPI:1124365515
Name:HALL, STEVEN A JR
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:HALL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5515 BIG RED CT UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-2540
Mailing Address - Country:US
Mailing Address - Phone:909-837-0033
Mailing Address - Fax:
Practice Address - Street 1:5515 BIG RED CT UNIT 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-2540
Practice Address - Country:US
Practice Address - Phone:909-837-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst