Provider Demographics
NPI:1346821949
Name:HALL, JONNA MASON (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:JONNA
Middle Name:MASON
Last Name:HALL
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4824 MORNING EDGE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-7169
Mailing Address - Country:US
Mailing Address - Phone:919-270-6730
Mailing Address - Fax:
Practice Address - Street 1:104 MARKET ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27537-3751
Practice Address - Country:US
Practice Address - Phone:252-431-4418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3459235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist