Healthcare Provider Details

I. General information

NPI: 1326709783
Provider Name (Legal Business Name): STEPHANIE MARIE O'NEILL BT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6504 MOUNTAINDALE RD
THURMONT MD
21788-2719
US

IV. Provider business mailing address

7537 UNIVERSITY RD
BOONSBORO MD
21713-2529
US

V. Phone/Fax

Practice location:
  • Phone: 443-243-7647
  • Fax:
Mailing address:
  • Phone: 302-465-8467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: