Individual
AMANDA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 KESWICK DR, NORFOLK, VA 23518-4926
(757) 275-5901
Mailing address
1700 KESWICK DR, NORFOLK, VA 23518-4926
(757) 275-5901
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
351139448011
—
VA
Enumeration date
06/03/2021
Last updated
06/03/2021
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