Provider Demographics
NPI:1629557053
Name:HALL, BRITTANY NOEL
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NOEL
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7477 VALLEY VIEW PL APT 304
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-3064
Mailing Address - Country:US
Mailing Address - Phone:304-651-4540
Mailing Address - Fax:
Practice Address - Street 1:521 S APPLE ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45118-8461
Practice Address - Country:US
Practice Address - Phone:513-875-3520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21404000103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool