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General NPI Number Information
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NPI Number | 1336828672
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Entity Type | Individual
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Provider Name | TERRANCE EARL O'NEAL
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Gender | Male
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Dates
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Enumeration Date | 07/13/2023
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 1804 E 55TH ST
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City | CLEVELAND
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State | OH
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Zip | 44103-3602
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Country | US
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Telephone | 405-520-7149
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Fax |
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Provider Business Mailing Address
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Address Line | 11807 N LANE DR APT 1
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City | LAKEWOOD
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State | OH
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Zip | 44107-2921
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Country | US
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Telephone | 405-520-7149
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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