Healthcare Provider Details

I. General information

NPI: 1770428559
Provider Name (Legal Business Name): ASHLYNN DANIELLE MCNEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N DALTON ST
VALLIANT OK
74764-8029
US

IV. Provider business mailing address

703 CATS EYE LOOP
IDABEL OK
74745-6257
US

V. Phone/Fax

Practice location:
  • Phone: 580-203-3600
  • Fax: 833-402-9799
Mailing address:
  • Phone: 580-203-3600
  • Fax: 833-402-9799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: