Individual
THOMAS BRANT HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1302 CALLE DE LA MERCED, ESPANOLA, NM 87532-2624
(505) 747-0081
Mailing address
557 E 9TH ST, LOVELAND, CO 80537-4923
(505) 455-6967
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
C-09466
NM
1041C0700X
Clinical Social Worker
Primary
CSW.09924914
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02032279
—
NM
Enumeration date
08/14/2012
Last updated
04/05/2018
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