Provider Demographics
NPI:1235534470
Name:HALL, REGINA (HCP)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:HCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3326
Mailing Address - Country:US
Mailing Address - Phone:304-314-2736
Mailing Address - Fax:513-332-7725
Practice Address - Street 1:1505 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3326
Practice Address - Country:US
Practice Address - Phone:304-314-2736
Practice Address - Fax:513-332-7725
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1032237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist