Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003403916 |
---|---|
Provider Name | Jaleel Mcneil |
First Address | Lawrenceville, GA 30043-5993 |
Second Address | Dunwoody, GA 30338-7404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2020 |
Last Update Date | 26/12/2020 |