Individual
DEIDRE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5662
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
871312
TX
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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