Provider Demographics
NPI:1821568163
Name:HALL, CRISTIN MARIE
Entity Type:Individual
Prefix:DR
First Name:CRISTIN
Middle Name:MARIE
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 1:133 TOWHEE DR
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-1764
Mailing Address - Country:US
Mailing Address - Phone:814-232-0008
Mailing Address - Fax:
Practice Address - Street 1:315 S ALLEN ST STE 218
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4850
Practice Address - Country:US
Practice Address - Phone:814-234-3010
Practice Address - Fax:814-234-2170
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017969103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist