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Individual

KATHLEEN A HALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
2501 RIO GRANDE BLVD NW STE A, ALBUQUERQUE, NM 87104-3233
(505) 321-0794
Mailing address
2501 RIO GRANDE BLVD NW STE A, ALBUQUERQUE, NM 87104-3233
(505) 321-0794

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-4153
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000Z5411
NM
01
201027601
PRESBYTERIAN PROVIDER NUM
NM
05
NM101453
NM
Enumeration date
12/11/2006
Last updated
01/02/2025
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