Provider Demographics
NPI:1255707295
Name:HALL, MEGAN L
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:L
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ABA
Mailing Address - Street 1:125 DILLMONT DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4658
Mailing Address - Country:US
Mailing Address - Phone:614-844-5433
Mailing Address - Fax:614-985-1956
Practice Address - Street 1:125 DILLMONT DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4658
Practice Address - Country:US
Practice Address - Phone:614-844-5433
Practice Address - Fax:614-985-1956
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-13
Last Update Date:2020-11-05
Deactivation Date:2016-02-17
Deactivation Code:
Reactivation Date:2020-11-05
Provider Licenses
StateLicense IDTaxonomies
OHCOBA.126103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOBA.126OtherSTATE LICENSE