Provider Demographics
NPI:1306443791
Name:HALL, JULIE ANN (TEACHER)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:HALL
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ALLEGANY
Mailing Address - State:NY
Mailing Address - Zip Code:14706-9669
Mailing Address - Country:US
Mailing Address - Phone:716-904-3196
Mailing Address - Fax:
Practice Address - Street 1:2326 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:ALLEGANY
Practice Address - State:NY
Practice Address - Zip Code:14706-9669
Practice Address - Country:US
Practice Address - Phone:716-904-3196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY90897899171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor