Provider Demographics
NPI:1174023998
Name:HALL, SONIA (BCBA)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:
Other - Last Name:RITCHIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6365 N 400 E
Mailing Address - Street 2:
Mailing Address - City:KENDALLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46755-9346
Mailing Address - Country:US
Mailing Address - Phone:260-336-3350
Mailing Address - Fax:
Practice Address - Street 1:6365 N 400 E
Practice Address - Street 2:
Practice Address - City:KENDALLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46755-9346
Practice Address - Country:US
Practice Address - Phone:260-336-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
1-20-44386103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician