Provider Demographics
NPI:1881825511
Name:HALL, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 SPRINGDALE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2841
Mailing Address - Country:US
Mailing Address - Phone:610-363-1488
Mailing Address - Fax:
Practice Address - Street 1:835 SPRINGDALE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2841
Practice Address - Country:US
Practice Address - Phone:610-363-1488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006506L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist