Individual
LISA J HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1600 JOHN ADAMS PKWY STE 102, IDAHO FALLS, ID 83401-4300
(208) 529-5276
(208) 529-6506
Mailing address
120 N 200 W FL 1, SALT LAKE CITY, UT 84103-1511
(800) 537-1000
(801) 240-6150
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
33507
ID
Other
Enumeration date
03/16/2010
Last updated
10/10/2016
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