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General NPI Number Information
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NPI Number | 1750828380
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Entity Type | Individual
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Provider Name | VONNIE NEALON
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Gender | Female
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Dates
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Enumeration Date | 01/20/2017
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Last Update Date | 01/20/2017
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Provider Practice Location Address
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Address Line | 756 PURPLE SAGE RD
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City | BANDERA
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State | TX
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Zip | 78003
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Country | US
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Telephone | 210-872-3890
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Fax |
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Provider Business Mailing Address
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Address Line | 190 TRACKS TRAIL
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City | CENTER POINT
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State | TX
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Zip | 78010
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Country | US
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Telephone | 210-872-3890
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 8346
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License Number State | TX
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