Provider Demographics
NPI:1508256322
Name:MCNEELY, KATHLEEN MARY (MS, CNS, LDN)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARY
Last Name:MCNEELY
Suffix:
Gender:F
Credentials:MS, CNS, LDN
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:MARY
Other - Last Name:MCNEELY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CNS, LDN
Mailing Address - Street 1:1220 12TH STREET, SE
Mailing Address - Street 2:UNITY HEALTH CARE, INC.
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003
Mailing Address - Country:US
Mailing Address - Phone:202-715-7949
Mailing Address - Fax:
Practice Address - Street 1:1220 12TH STREET, SE
Practice Address - Street 2:UNITY HEALTH CARE, INC.
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003
Practice Address - Country:US
Practice Address - Phone:202-715-7949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-01
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3757133N00000X
DCNU 100000185133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist