Provider Demographics
NPI:1811689045
Name:HALL, EMMA (LSW)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 PORTAGE POINTE DR APT J107
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-6306
Mailing Address - Country:US
Mailing Address - Phone:412-779-7846
Mailing Address - Fax:
Practice Address - Street 1:2275 STATE ROUTE 59
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-7143
Practice Address - Country:US
Practice Address - Phone:330-593-5959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker