MEDICARE: MRS. LINDSAY DIAZ MCNEELY MS, CGC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1841629268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDSAY DIAZ MCNEELY MS, CGC

Provider Business Mailing Address
First Line	:	1015 GLENWOOD AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-4402
Country	:	US
Telephone Number	:
Fax Number	:	612-808-5186

Provider Business Practice Location Address
First Line	:	1015 GLENWOOD AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-4402
Country	:	US
Telephone Number	:	866-741-5331
Fax Number	:	612-808-5186

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	05/12/2020

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