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Individual

MRS. KELLY M HALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
SIERRA VERDE RANCH 4, LOT 190, SELIGMAN, AZ 86337-0599
(928) 226-1097
Mailing address
PO BOX 599, SELIGMAN, AZ 86337-0599
(928) 226-1097

Taxonomy

Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
9405
AZ

Other

Enumeration date
02/02/2007
Last updated
07/08/2007
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