Provider Demographics
NPI:1538416771
Name:DR. MORGAIN HALL, PLLC
Entity type:Organization
Organization Name:DR. MORGAIN HALL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:MORGAIN
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:515-222-1175
Mailing Address - Street 1:1000 73RD STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324-1321
Mailing Address - Country:US
Mailing Address - Phone:515-222-1175
Mailing Address - Fax:515-222-0953
Practice Address - Street 1:1000 73RD STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-1321
Practice Address - Country:US
Practice Address - Phone:515-222-1175
Practice Address - Fax:515-222-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001053103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty