Individual
JEANELLA ALLS HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
865 DEWEY JOHNSON WAY, GRETNA, FL 32332-2311
(850) 556-7401
Mailing address
865 DEWEY JOHNSON WAY, GRETNA, FL 32332-2311
(850) 556-7404
(850) 627-1065
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
671397
—
FL
01
—
H400421799190
DRIVER LICENSE
FL
Enumeration date
05/31/2017
Last updated
05/31/2017
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