Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003037698 |
---|---|
Provider Name | Scott A Hall |
First Address | Clarkston, MI 48346-3357 |
Second Address | Clarkston, MI 48346-3357 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 20/05/2013 |