Individual
MS. SUBRENIA A HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2637 N SARTAIN ST, PHILADELPHIA, PA 19133-1411
(267) 242-1928
Mailing address
2637 N SARTAIN ST, PHILADELPHIA, PA 19133-1411
(267) 242-1928
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
BH003188
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH003188
STATE BOARD OF MEDICINE
PA
Enumeration date
07/21/2019
Last updated
07/21/2019
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