Provider Demographics
NPI:1346872637
Name:HALL, ANTOINE SAMUEL (MSW)
Entity Type:Individual
Prefix:MR
First Name:ANTOINE
Middle Name:SAMUEL
Last Name:HALL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 RICHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-4121
Mailing Address - Country:US
Mailing Address - Phone:610-931-5877
Mailing Address - Fax:
Practice Address - Street 1:2275 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19137-1300
Practice Address - Country:US
Practice Address - Phone:215-772-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health