Provider Demographics
NPI:1568620292
Name:HALL, WHITNEY DEVON (PHD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:DEVON
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:PO BOX 5621
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78763-5621
Mailing Address - Country:US
Mailing Address - Phone:512-909-9865
Mailing Address - Fax:
Practice Address - Street 1:3906 N LAMAR BLVD
Practice Address - Street 2:STE 202B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4000
Practice Address - Country:US
Practice Address - Phone:512-909-9865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33423103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K8574Medicare PIN