MEDICARE: DR. CHERYL BODIFORD MCNEIL PH.D.

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
1	103TC0700X	Clinical Psychologist	11529	FL

General Provider Information

NPI Number	:	1982331906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL BODIFORD MCNEIL PH.D.

Provider Business Mailing Address
First Line	:	4530 SW 81ST TER
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-4214
Country	:	US
Telephone Number	:	304-692-6628
Fax Number	:

Provider Business Practice Location Address
First Line	:	4197 NW 86TH TER
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-9278
Country	:	US
Telephone Number	:	304-692-6628
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2022
Last Update Date	:	08/01/2022

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