Provider Demographics
NPI:1306553805
Name:HALO, LAURA W
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:W
Last Name:HALO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COUNTY COMPLEX CT STE 240
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-9205
Mailing Address - Country:US
Mailing Address - Phone:703-792-7425
Mailing Address - Fax:
Practice Address - Street 1:5 COUNTY COMPLEX CT STE 240
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-9205
Practice Address - Country:US
Practice Address - Phone:703-792-7425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAV00013OtherVA BILLING OF ADMINISTRATIVE FEES FOR PERSONAL IN HOME PPL DIRECT CARE
VAV000016OtherVA BILLING OF ADMINISTRATIVE FEES FOR PERSONAL IN HOME PPL DIRECT CARE