| Doctor Name: | DR. MIA YVETTE HALL |
| NPI Number: | 1013211713 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DMFT & LCSW |
| License Number: | SW4023 |
| Business Practice Address: | 121 N 2nd St Suite301 Fort Pierce, FL - 349504435 |
| Business Phone Number: | 7725953773 |
| Business Fax Number: | 7724640087 |
| Mailing Address: | 121 Nort Second Street, Suite301 FT. PIERCE |
| State: | FL |
| Postal Code: | 34950 |
| Phone Number: | 7725953773 |
| Fax Number: | 7724640087 |
| NPI Enumeration Date: | 01/10/2011 |
| NPI Last Update Date: | 01/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW4023 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |