Provider Demographics
NPI:1811246069
Name:HALL, VALERIE ELIZABETH (MS)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:ELIZABETH
Last Name:HALL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2427
Mailing Address - Country:US
Mailing Address - Phone:516-509-6734
Mailing Address - Fax:
Practice Address - Street 1:3807 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2427
Practice Address - Country:US
Practice Address - Phone:516-509-6734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1403162103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool