Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | IMH11141 | FL |
N | 101YS0200X | School Counselor | FL |
NPI | 1003256363 |
---|---|
Provider Name | Dr. Amy L Hall |
First Address | Daytona Beach, FL 32119-1381 |
Second Address | Daytona Beach, FL 32119-1381 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2013 |
Last Update Date | 01/07/2013 |