Provider Demographics
NPI:1386306348
Name:HALL, ALLYSON GRACE
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:GRACE
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 1:14829 BERT CAMERON AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-3130
Mailing Address - Country:US
Mailing Address - Phone:813-451-3245
Mailing Address - Fax:
Practice Address - Street 1:14829 BERT CAMERON AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-3130
Practice Address - Country:US
Practice Address - Phone:813-451-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician