Provider Demographics
NPI:1417657206
Name:HALL, HOOVER III (PHD)
Entity Type:Individual
Prefix:DR
First Name:HOOVER
Middle Name:
Last Name:HALL
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7055 LUCKY DR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-4106
Mailing Address - Country:US
Mailing Address - Phone:904-294-2699
Mailing Address - Fax:
Practice Address - Street 1:7055 LUCKY DR E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-4106
Practice Address - Country:US
Practice Address - Phone:904-294-2699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist