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General NPI Number Information
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NPI Number | 1922380799
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Entity Type | Individual
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Provider Name | SUE BURDETTE O'NEILL LPC
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Gender | Female
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 59468 HIGHWAY 49
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City | LINEVILLE
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State | AL
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Zip | 36266-4769
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Country | US
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Telephone | 256-276-1451
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Fax |
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Provider Business Mailing Address
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Address Line | 88154 HIGHWAY 9 PO POX 366
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City | LINEVILLE
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State | AL
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Zip | 36266-6932
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Country | US
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Telephone | 256-276-1451
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Fax | 256-396-5977
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 150
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License Number State | AL
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