Provider Demographics
NPI:1508948175
Name:HALL, DESNEE ALISON (PHD)
Entity Type:Individual
Prefix:DR
First Name:DESNEE
Middle Name:ALISON
Last Name:HALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WEYBURN RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3612
Mailing Address - Country:US
Mailing Address - Phone:914-472-9848
Mailing Address - Fax:
Practice Address - Street 1:7 WEYBURN RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3612
Practice Address - Country:US
Practice Address - Phone:914-472-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012379103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01727224Medicaid
NYV0374Medicare ID - Type Unspecified