Provider Demographics
NPI:1679205751
Name:HALL, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:STATEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8308 OHIO RIVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-1713
Mailing Address - Country:US
Mailing Address - Phone:740-529-1201
Mailing Address - Fax:740-876-8854
Practice Address - Street 1:8308 OHIO RIVER RD STE B
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-1713
Practice Address - Country:US
Practice Address - Phone:740-529-1201
Practice Address - Fax:740-876-8854
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator