Basic Information
| Provider Information | |||||||||
| NPI: | 1548775968 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALL | ||||||||
| FirstName: | CHENAIL | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | BS, COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2506 WOODVIEW DR | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198082528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026075771 | ||||||||
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| Practice Location | |||||||||
| Address1: | 505 GREENBANK RD | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198083164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3029980101 | ||||||||
| FaxNumber: | 8552328604 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2017 | ||||||||
| LastUpdateDate: | 03/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | U2-0001501 | DE | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.