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Individual
MR. KEVIN A HALL
Active
Individual
MR. KEVIN A HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1021510
MA
1041C0700X
Clinical Social Worker
ISW01293
RI
Other
Enumeration date
01/21/2010
Last updated
12/20/2010
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