Provider Demographics
NPI:1750719332
Name:HALL, LORI KATHRYN (PSYD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:KATHRYN
Last Name:HALL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S STERLING ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3938
Mailing Address - Country:US
Mailing Address - Phone:828-433-2111
Mailing Address - Fax:828-433-2250
Practice Address - Street 1:1000 S STERLING ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3938
Practice Address - Country:US
Practice Address - Phone:828-433-2111
Practice Address - Fax:828-433-2250
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4526103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical