Provider Demographics
NPI:1336611417
Name:HALL, MARIA TERESA (PLMHP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA
Last Name:HALL
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 S EMORY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-0300
Mailing Address - Country:US
Mailing Address - Phone:308-539-0887
Mailing Address - Fax:
Practice Address - Street 1:1002 E PHILIP AVE
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6104
Practice Address - Country:US
Practice Address - Phone:308-532-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-29
Last Update Date:2018-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health