Provider Demographics
NPI:1750611752
Name:TINA HALL, INC
Entity type:Organization
Organization Name:TINA HALL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:479-430-6398
Mailing Address - Street 1:1518 HIGHWAY 71 SE
Mailing Address - Street 2:BOX 76
Mailing Address - City:MOUNTAINBURG
Mailing Address - State:AR
Mailing Address - Zip Code:72946-3000
Mailing Address - Country:US
Mailing Address - Phone:479-430-6398
Mailing Address - Fax:
Practice Address - Street 1:1518 HIGHWAY 71 SE
Practice Address - Street 2:BOX 76
Practice Address - City:MOUNTAINBURG
Practice Address - State:AR
Practice Address - Zip Code:72946-3000
Practice Address - Country:US
Practice Address - Phone:479-430-6398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2310252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency