Provider Demographics
NPI:1093406092
Name:MACNEALY, HAILEY BRIANNA
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:BRIANNA
Last Name:MACNEALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 ALT 19 STE 6
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-2631
Mailing Address - Country:US
Mailing Address - Phone:813-389-0841
Mailing Address - Fax:
Practice Address - Street 1:2311 ALT 19 STE 6
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-2631
Practice Address - Country:US
Practice Address - Phone:727-343-3662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health