Provider Demographics
NPI:1942004528
Name:HALL, ANDREA GAYLE
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:GAYLE
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 COBBLESTONE LN
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-4653
Mailing Address - Country:US
Mailing Address - Phone:214-315-4819
Mailing Address - Fax:
Practice Address - Street 1:1911 COBBLESTONE LN
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-4653
Practice Address - Country:US
Practice Address - Phone:214-315-4819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97139101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional