Provider Demographics
NPI:1215589304
Name:O'NEAL, JACLYN K (COTA)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:K
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9162 SHARPTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:DE
Mailing Address - Zip Code:19956-4308
Mailing Address - Country:US
Mailing Address - Phone:302-841-1485
Mailing Address - Fax:
Practice Address - Street 1:191 WESTMINSTER DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-8717
Practice Address - Country:US
Practice Address - Phone:302-744-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant