Provider Demographics
NPI:1922655513
Name:HALL, ANGELIA
Entity Type:Individual
Prefix:MS
First Name:ANGELIA
Middle Name:
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:PO BOX 690642
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-0011
Mailing Address - Country:US
Mailing Address - Phone:254-368-0633
Mailing Address - Fax:
Practice Address - Street 1:1519 FLORENCE RD STE 14
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-7903
Practice Address - Country:US
Practice Address - Phone:254-368-0633
Practice Address - Fax:254-294-2223
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74627101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor