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General NPI Number Information
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NPI Number | 1528536695
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Entity Type | Individual
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Provider Name | CHRISTIAN O'NEAL
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Gender | Male
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 400 JOHNSON ST
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City | ALPENA
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State | MI
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Zip | 49707-1434
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Country | US
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Telephone | 989-356-2161
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Fax |
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Provider Business Mailing Address
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Address Line | 411 S 4TH AVE APT A
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City | ALPENA
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State | MI
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Zip | 49707-2779
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Country | US
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Telephone | 989-884-9160
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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