Individual
JONATHAN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LADC
Contact information
Practice address
75 LINDALL ST, DANVERS, MA 01923-2121
(978) 571-1700
Mailing address
2701 RENAISSANCE BLVD FL 4, KING OF PRUSSIA, PA 19406-2781
(610) 994-2993
(484) 393-4096
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
873
MA
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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