Healthcare Provider Details

I. General information

NPI: 1639002694
Provider Name (Legal Business Name): CHRISTINA LAUREN MCNEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 W FAIRMONT AVE UNIT 100 FL 1
SAVANNAH GA
31406-3456
US

IV. Provider business mailing address

103 W GENERAL SCREVEN WAY STE G PMB 1098
HINESVILLE GA
31313-3053
US

V. Phone/Fax

Practice location:
  • Phone: 912-532-9774
  • Fax: 912-221-3085
Mailing address:
  • Phone: 912-532-9774
  • Fax: 912-221-3085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-338169
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: