Individual
LAURIE HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3301 N BALLARD RD STE C, APPLETON, WI 54911-9002
(920) 202-3954
(920) 202-3964
Mailing address
3301 N BALLARD RD STE C, APPLETON, WI 54911-9002
(920) 202-3954
(920) 202-3964
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
15823
NY
103TC0700X
Clinical Psychologist
Primary
2719-057
WI
103TC0700X
Clinical Psychologist
613
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407989791
—
WI
Enumeration date
03/14/2007
Last updated
11/18/2010
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