Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CDCA.160748 | OH |
NPI | 1003358367 |
---|---|
Provider Name | Tena M Mcneil |
First Address | Dayton, OH 45417-3424 |
Second Address | Dayton, OH 45417-3424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2016 |
Last Update Date | 18/11/2016 |