Provider Demographics
NPI:1972048817
Name:HALL, ANNA MAREE (MCD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MAREE
Last Name:HALL
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 GOLF COURSE DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4565
Mailing Address - Country:US
Mailing Address - Phone:501-322-0505
Mailing Address - Fax:
Practice Address - Street 1:1001 GOLF COURSE DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4565
Practice Address - Country:US
Practice Address - Phone:501-322-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12178235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist