| Gerald Hall Llc | |
|
102 Sw 12th St Lawton OK 73501-3810 | |
| (580) 351-0242 | |
| (580) 351-0282 |
| Full Name | Gerald Hall Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 102 Sw 12th St, Lawton, Oklahoma |
| Authorized Official Name and Position | Leatisha R Dubose (OFFICE MANAGER) |
| Authorized Official Contact | 5803510242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerald Hall Llc 102 Sw 12th St Lawton OK 73501-3810 Ph: (580) 351-0242 | Gerald Hall Llc 102 Sw 12th St Lawton OK 73501-3810 Ph: (580) 351-0242 |
| NPI Number | 1588725295 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588725295 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 789 (Oklahoma) | Primary |
| 106H00000X | Marriage & Family Therapist | 562 (Oklahoma) | Primary |
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