Provider Demographics
NPI:1023725926
Name:STREGE, HALLE K (LAT, ATC, CES)
Entity type:Individual
Prefix:
First Name:HALLE
Middle Name:K
Last Name:STREGE
Suffix:
Gender:F
Credentials:LAT, ATC, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 CAMERON ELLIS DR APT 202
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8994
Mailing Address - Country:US
Mailing Address - Phone:317-263-4252
Mailing Address - Fax:
Practice Address - Street 1:3430 OHIOHEALTH PARKWAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202
Practice Address - Country:US
Practice Address - Phone:317-263-4252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36003744A2255A2300X
390200000X
OHAT0067852255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program