Provider Demographics
NPI:1255648986
Name:HALL, NORMAN E (MS CAS SCHOOL PSYCH)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:E
Last Name:HALL
Suffix:
Gender:M
Credentials:MS CAS SCHOOL PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 JEFFERSON AVE
Mailing Address - Street 2:GRANT COUNTY BOARD OF EDUCATION
Mailing Address - City:PETERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26847
Mailing Address - Country:US
Mailing Address - Phone:304-267-3595
Mailing Address - Fax:
Practice Address - Street 1:204 JEFFERSON AVE
Practice Address - Street 2:GRANT COUNTY BOARD OF EDUCATION
Practice Address - City:PETERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26847
Practice Address - Country:US
Practice Address - Phone:304-267-3595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1652103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool