Provider Demographics
NPI:1376190983
Name:HALL, DEVON (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8013 DEERFIELD CMNS
Mailing Address - Street 2:
Mailing Address - City:SHIPPENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17257-8550
Mailing Address - Country:US
Mailing Address - Phone:727-432-2051
Mailing Address - Fax:
Practice Address - Street 1:1134 KENNEBEC DR STE B
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2809
Practice Address - Country:US
Practice Address - Phone:717-446-0439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL014629235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist