Provider Demographics
NPI:1285105031
Name:HALL, DEBORAH DAVIS (EDD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:DAVIS
Last Name:HALL
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 WILLIAM HILTON PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2498
Mailing Address - Country:US
Mailing Address - Phone:843-547-0200
Mailing Address - Fax:843-681-4645
Practice Address - Street 1:460 WILLIAM HILTON PKWY STE B
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2498
Practice Address - Country:US
Practice Address - Phone:843-547-0200
Practice Address - Fax:843-681-4645
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional