Provider Demographics
NPI:1396514774
Name:HALL, CAITLIN MARIE
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARIE
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 1:501 N CLINIC ST
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4608
Mailing Address - Country:US
Mailing Address - Phone:407-765-3922
Mailing Address - Fax:
Practice Address - Street 1:400 W CAPITOL AVE STE 1700
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-3438
Practice Address - Country:US
Practice Address - Phone:919-375-0475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician