Provider Demographics
NPI:1942732631
Name:HALL, REGINA J
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:J
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 1:560 BELLE TERRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-1715
Mailing Address - Country:US
Mailing Address - Phone:985-652-0078
Mailing Address - Fax:985-652-8360
Practice Address - Street 1:560 BELLE TERRE BLVD
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068
Practice Address - Country:US
Practice Address - Phone:985-652-0078
Practice Address - Fax:985-652-8360
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health