Provider Demographics
NPI:1639358666
Name:HALL, PATRICIA ANN (MA, CLC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:HALL
Suffix:
Gender:F
Credentials:MA, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 NELSON CT
Mailing Address - Street 2:15251 PLEASANT VALLEY RD
Mailing Address - City:CENTER CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55012-3500
Mailing Address - Country:US
Mailing Address - Phone:651-213-4301
Mailing Address - Fax:
Practice Address - Street 1:15251 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:CENTER CITY
Practice Address - State:MN
Practice Address - Zip Code:55012-9640
Practice Address - Country:US
Practice Address - Phone:651-213-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor