Provider Demographics
NPI:1386403012
Name:HALL, JULIAN MYRON
Entity type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:MYRON
Last Name:HALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 MAIN ST FRNT DOOR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1540
Mailing Address - Country:US
Mailing Address - Phone:717-271-8767
Mailing Address - Fax:
Practice Address - Street 1:4201 MAIN ST FRNT DOOR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1540
Practice Address - Country:US
Practice Address - Phone:717-271-8767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health