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General NPI Number Information
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NPI Number | 1477072510
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Entity Type | Individual
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Provider Name | THERESE M MCNEELY LSW
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Gender | Female
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Dates
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Enumeration Date | 09/10/2017
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Last Update Date | 09/10/2017
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Provider Practice Location Address
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Address Line | 26032 DETROIT RD STE 1
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City | WESTLAKE
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State | OH
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Zip | 44145-2478
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Country | US
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Telephone | 440-250-9414
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Fax |
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Provider Business Mailing Address
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Address Line | 32907 FOX CHAPPEL LN
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City | AVON LAKE
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State | OH
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Zip | 44012-2337
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Country | US
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Telephone | 216-392-4418
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | S.1701327
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License Number State | OH
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