Provider Demographics
NPI:1245607621
Name:MCNEIL, JAMES HAROLD (SLPA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HAROLD
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 S WILSON ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-5532
Mailing Address - Country:US
Mailing Address - Phone:480-593-4561
Mailing Address - Fax:
Practice Address - Street 1:1024 S WILSON ST
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-5532
Practice Address - Country:US
Practice Address - Phone:480-593-4561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA95762355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZSLPA9576OtherARIZONA DEPARTMENT OF HEALTH SERVICES