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NPI Code Detail

MEDICARE: JOHNNETTE LA'NEL O'NEAL

MEDICARE:   JOHNNETTE LA'NEL O'NEAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1689201881
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHNNETTE LA'NEL O'NEAL
Provider Business Mailing Address
First Line : 25925 BUDDE RD
Second Line :
City : SPRING
State : TX
Zip : 77380-2011
Country : US
Telephone Number : 281-465-4468
Fax Number : 832-442-5334
Provider Business Practice Location Address
First Line : 25925 BUDDE RD
Second Line :
City : SPRING
State : TX
Zip : 77380-2011
Country : US
Telephone Number : 281-465-4468
Fax Number : 832-442-5334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2020
Last Update Date : 03/26/2020

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Directions to “ JOHNNETTE LA'NEL O'NEAL ” Practice Location

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