Individual
BREDA FAYE HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1531 HIGHLAND COLONY PKWY, MADISON, MS 39110-7469
(601) 506-1459
Mailing address
PO BOX 1643, BRANDON, MS 39043-1643
(601) 951-1583
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0083571
NM
101YP1600X
Pastoral Counselor
0083571
NM
101YP2500X
Professional Counselor
0083571
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-0877337
DEPT. OF TREASURY, IRS
MS
Enumeration date
03/24/2008
Last updated
12/18/2008
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