Provider Demographics
NPI:1053904524
Name:MCNEIL, JACQUELINE YVONNE (SLPA)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:YVONNE
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:753 NW FORT SILL BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-5498
Mailing Address - Country:US
Mailing Address - Phone:580-357-6900
Mailing Address - Fax:580-585-6405
Practice Address - Street 1:753 NW FORT SILL BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73507-5498
Practice Address - Country:US
Practice Address - Phone:580-357-6900
Practice Address - Fax:580-585-6405
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK235Z00000X, 2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist