Basic Information
| Provider Information | |||||||||
| NPI: | 1396916334 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | O'NEAL | ||||||||
| FirstName: | LEE | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 876 | ||||||||
| Address2: | |||||||||
| City: | COARSEGOLD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936140876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4086798104 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1925 E DAKOTA AVE | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937264821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596004598 | ||||||||
| FaxNumber: | 5594554633 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2008 | ||||||||
| LastUpdateDate: | 12/14/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC44874 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.