Basic Information
Provider Information
NPI: 1750759700
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HALL
FirstName: KATHERINE
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1912 RISING SUN LN
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198073033
CountryCode: US
TelephoneNumber: 4156019185
FaxNumber:  
Practice Location
Address1: 61 CORPORATE CIR
Address2:  
City: NEW CASTLE
State: DE
PostalCode: 197202439
CountryCode: US
TelephoneNumber: 3023244444
FaxNumber: 3023244441
Other Information
ProviderEnumerationDate: 09/08/2015
LastUpdateDate: 09/15/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000XU1-0001619DEY Other Service ProvidersSpecialist 

No ID Information.


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