Basic Information
| Provider Information | |||||||||
| NPI: | 1225319916 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'NEIL | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | STANLEY | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2770 CEDAR VALLEY DR | ||||||||
| Address2: | |||||||||
| City: | HOWELL | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488438935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173769250 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11930 WHITMORE LAKE RD # 1 | ||||||||
| Address2: | |||||||||
| City: | WHITMORE LAKE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481899153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344494649 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2011 | ||||||||
| LastUpdateDate: | 09/08/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.