Provider Demographics
NPI:1457678930
Name:HALL, ALIAH (CSW)
Entity Type:Individual
Prefix:
First Name:ALIAH
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E 4500 S STE 260
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3954
Mailing Address - Country:US
Mailing Address - Phone:801-380-8015
Mailing Address - Fax:
Practice Address - Street 1:345 E 4500 S STE 260
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3954
Practice Address - Country:US
Practice Address - Phone:801-380-8015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6060610-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical