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General NPI Number Information
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NPI Number | 1598422388
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Entity Type | Individual
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Provider Name | TERRENCE MICHAEL O'NEILL IMH
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Gender | Male
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 2465 MERCER AVE STE 204
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-7449
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Country | US
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Telephone | 561-301-2428
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Fax |
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Provider Business Mailing Address
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Address Line | 177 BEDFORD G
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-2243
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Country | US
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Telephone | 561-301-2428
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH16165
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License Number State | FL
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