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Individual

JIMMIE L HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
PINON AND COTTONWOOD DRIVE BLDG 2301, SHIPROCK, NM 87420-1830
(505) 368-1438
(505) 368-1452
Mailing address
PO BOX 1830, SHIPROCK, NM 87420-1830
(505) 368-1438
(505) 368-1452

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0185301
NM
101YM0800X
Mental Health Counselor

Other

Enumeration date
11/30/2010
Last updated
02/21/2022
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