Provider Demographics
NPI:1295093797
Name:HALL, DEBORAH LYNNE (OTR/L)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNNE
Last Name:HALL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 TEE BOX DR
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-7280
Mailing Address - Country:US
Mailing Address - Phone:305-962-3120
Mailing Address - Fax:305-962-3120
Practice Address - Street 1:5600 COLLINS AVE APT 11P
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2411
Practice Address - Country:US
Practice Address - Phone:305-865-3111
Practice Address - Fax:305-865-3111
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10253225X00000X
KY164019225X00000X
GA006195225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist