Provider Demographics
NPI:1790231017
Name:ANNIE HALL MARRIAGE AND FAMILY THERAPY, INC.
Entity Type:Organization
Organization Name:ANNIE HALL MARRIAGE AND FAMILY THERAPY, INC.
Other - Org Name:ANNE L HALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:858-300-0480
Mailing Address - Street 1:2333 CAMINO DEL RIO SOUTH
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3617
Mailing Address - Country:US
Mailing Address - Phone:858-300-0480
Mailing Address - Fax:
Practice Address - Street 1:2333 CAMINO DEL RIO SOUTH
Practice Address - Street 2:SUITE 160
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3617
Practice Address - Country:US
Practice Address - Phone:858-300-0480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty