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General NPI Number Information
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NPI Number | 1245534734
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Entity Type | Individual
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Provider Name | TERESA LYNN MCNEIL L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 12/27/2010
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | 2004 S JOPLIN AVE
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City | JOPLIN
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State | MO
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Zip | 64804-2032
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Country | US
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Telephone | 417-623-8933
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Fax | 417-623-3223
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Provider Business Mailing Address
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Address Line | 2004 S JOPLIN AVE
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City | JOPLIN
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State | MO
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Zip | 64804-2032
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Country | US
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Telephone | 417-623-8933
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Fax | 417-623-3223
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2010036933
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License Number State | MO
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