Individual
MS. MARCELLE IDETTE BLAIR HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
205 N MONROE ST, MEDIA, PA 19063-3052
(610) 800-2475
Mailing address
2150 SPRINGHOUSE HOLW, GARNET VALLEY, PA 19060-2116
(610) 800-2475
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW125167
PA
1041C0700X
Clinical Social Worker
CW016320
PA
1041C0700X
Clinical Social Worker
Q1-0001254
DE
Other
Enumeration date
12/08/2006
Last updated
10/11/2017
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