Provider Demographics
NPI:1437976958
Name:HALL, STEFAN ALIN
Entity type:Individual
Prefix:
First Name:STEFAN
Middle Name:ALIN
Last Name:HALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15861 62ND PL N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3449
Mailing Address - Country:US
Mailing Address - Phone:561-446-4161
Mailing Address - Fax:
Practice Address - Street 1:15861 62ND PL N
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-3449
Practice Address - Country:US
Practice Address - Phone:561-446-4161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician