Individual
PEGGY JOLI REYNOLDS HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
12728 AUGUSTA AVE, OMAHA, NE 68144-3753
(402) 330-1537
(402) 330-9331
Mailing address
12728 AUGUSTA AVE, OMAHA, NE 68144-3753
(402) 330-1537
(402) 330-9331
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
849
NE
1041C0700X
Clinical Social Worker
Primary
269
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120644000
MAGELLAN
NE
05
—
470789060000
—
NE
Enumeration date
06/11/2006
Last updated
08/23/2012
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