Provider Demographics
NPI:1801066758
Name:HALL, MARK ALLEN (B A)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ALLEN
Last Name:HALL
Suffix:
Gender:M
Credentials:B A
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:142 E MAUMEE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-2735
Mailing Address - Country:US
Mailing Address - Phone:517-263-2625
Mailing Address - Fax:517-263-7369
Practice Address - Street 1:142 E MAUMEE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2735
Practice Address - Country:US
Practice Address - Phone:517-263-2625
Practice Address - Fax:517-263-7369
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)